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� r <br /> LOT LINE ADJUSTMENT <br /> SAN JOAQUIN CCIUNTYCOMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTN16RAZ47100Y WONATUR" <br /> axt r . . 6wnii a aF r4 ars ruI AVMar icaetii'Ma*+IL&ahr a arrox. ; <br /> t,the QwmerlAgent agree,to defend,lndemn fa,and hold harmless the County and Its agents,oJlRcers and employees thonr any claim,action or <br /> proceeding against the Owner/Agent's project <br /> 4 furthar, conft under penally of pwjury that I am(check one): <br /> 0,1"" Legal property owner(owner includes partner,trustee,trustor,or corporate officer)of the property(s)Involved In this <br /> application,or <br /> } O Legal agent(attach proof of the owner's consent to the application of the property's Involved in this appllcatlon and have <br /> been aulbortzed to file on their behaU.,and that the foregoing application Statements are true and correct <br /> r i <br /> f IM Date: <br /> Print Name: C l r .� I'1 �. 1�11 Signature: <br /> I Print Name: . "O n- ��.� �.i&n Signature: ��� ' Doty: <br /> , C1 [ �J <br /> Print Name: _ Signature: Date: <br /> f <br /> Print Name: _ Signature: Date: <br /> Print Name: _ - Signature: Data: _ <br /> E <br /> V <br /> f <br /> k <br /> r <br /> M03 AMPAJAM Februwy 1.1 Nu <br /> k <br />