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LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZED SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION <br /> I.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 /> I,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 propertyph 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 /> - r _ <br /> Print Name: "5G1- YY� . m-�Q,�D Signature: �(/� <br /> N T <br /> Y7, .�y_t'1�X� Date: p <br /> Print Name: yG / O.>}i Signature: 9x,�4n �.., Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />