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LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERrYOR AN AUTHORIZED AGENTMAYFILE AN APPLICATION' <br /> 1, the OwnerlAgent agree,to defend,Indemnity,and hold harmless the County and Its agents,oMcem and employees from any claim,action or <br /> proceeding against the OwnedAgent's project <br /> 1,further, 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 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 application and have <br /> been authorized to file on their behalf.,and that the foregoing application statements are true and correct, <br /> Print Name: Signature: <br /> Date: <br /> Pninf Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> ,om N.vti,uw rre.ry,.,aaa <br /> -4- <br />