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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> - -$ - <br /> ?IiI1 TH 'ItsfN `t ',�I1FFT1�.tR UT ? tI GRt fA FII . 1ll.i , <br /> 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees <br /> from any claim, action or proceeding against the Owner/Agent's project. <br /> I, further, certify under penalty of perjury that I am(check one): <br /> D Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> Legal agent(attach proof of the owner's consent to the application) of the owner of the property(s) <br /> involved in this application and have been aulApfized to Erle on their behalf, and that the foregoing <br /> application statements are true and correct to th "etof of my knowledge and belief. <br /> r <br /> j <br /> Print Name: Kathy Garcia _ 5ignatlrr : Date: 4ob <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />