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LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHOWATION SIGNATURES <br /> 3 <br /> ON[.Y THE OWNER OF-THE PROPERTY ORA" <br /> AUTHORIZED AGENT MAY FILE AN APPClCA TIOlIL <br /> 1, the Owner/Agent agree, to defend,indemnify,and hold harmless the County and its agents,officers and employees from any claim,action <br /> or proceeding against the Owner/Agent's project. <br /> 1, further, certify under penalty of perjury that I am(check one): <br /> 0 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 owners consent to the application of the property's involved in this application and <br /> have been authorized to File on their behalf.,and that the foregoing application statements are true and correct. <br /> a YL1 -1 v M r D* Signature: Date: <br /> Print Name: S <br /> Signature: <br /> Date: <br /> Si <br /> Print Name: G ��. g <br /> Date' <br /> Print!Name: <br /> Signature: � <br /> Print Name: <br /> Signature: Date: <br /> Print Name: <br /> Signature: Date: <br /> k I <br /> i <br /> I <br /> I <br /> E <br /> I <br /> I <br /> E <br /> I <br /> 1:11 P11PA LASE 10MO y 1,18811 -4- <br /> i <br />