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)T LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THEOWNER OF THE PROPERrYOR ANAUTHORIZEDAGENTMAYFILEAN APPLICATION. <br /> 1,the OwnenAgent agree,to defend,Indemnity,and hold harmless the County and Its agents,omcem and employees from any claim,action or <br /> proceeding against the Own"/Agent's project <br /> 1,Anther, certify under penalty of perjury that i am(check one): <br /> O Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the properry(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 application and have <br /> been authorized to file on their behalf.,and that the foregoing application statements are true and correct <br /> Print Name: �U� �u 1 �1 �CI�t. IP4Signet re: <br /> Print Name: �T®I"�� �/EIC,E�K.f�4M4-<A-L- <br /> � Signa Dats <br /> Pint Name: ,IJD N N t7 I1 , 4 M 14'-<I-1- Signature: ' Date: <br /> Print Name: ('Iyw/e 902e&'66 Signature: �Q/?G!-�zct� Date: <br /> /&L11� e-s <br /> Print Name: l .0Signature: _ A o Date: <br /> MiCNarz� Ilk . Pmt-(Lir-A <br /> Ja nc. b. M'I -ae 11 <br /> , <br /> i�tLm r� ►��� r�� � �,� �( Zvi al <br /> 10'W NAP/LLAB!FKwry 1 1pBp <br /> -4- <br />