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Lr'LINE LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMkr..4ITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES - <br /> OHL Y THE OWNER OF THE PROPERTYOR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the Owner/Agent agree,to defend,Indemnify,and hold harmless the County and Its agents,officers and employees from any claim,action or <br /> proceeding against the Owner/Agent's project. <br /> 1, further, carery under penalty of perjury that I am(check one): <br /> O Legal property owner(owner Includes partner,trustee,rustor,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 Ilia on their behalf.,and the(tile foregoing application statements are we and correct. <br /> _til [7/}f � n iJ4 �d Signature: �' l ct� ��.1 �O t v �rr� Date: <br /> Print Name: �D <br /> Pr'nt Name: <br /> (? PokAbn Signature: <br /> �/f/?7nRu= <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> 10.0.1 ANiti1NB FWuuY 1.1YGY <br /> -4- <br />