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LOT LINE ADJUSTMEN <br />SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br />t, <br />+1J G"laiwlfi�s C%9FbE��i Li�4rc C".�{ c <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 />.I <br />or proceeding against the Owner%Agent's project. <br />1, further, certify under penalty of perjury that I am (check one): <br />X Legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) involved in this <br />application, or <br />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: �.� q t@t t l;. !'t 48 Is Signature: -OA 44 Date: f » 7 Q s <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />-4• <br />