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LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMM. .Y DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLYTHEOWNEROF THE PROPERTY ORAN AUTHORIZED AGENT MAYFILE AN APPLMAT10N <br /> 1, tine OwnerlAgeni agree, to defend,Indemnity,and hold harmless the County and Its agents,officers and employees from any clalm,action or <br /> proceeding against the OwnervAgenf s project <br /> 1,further, coldly under penalty of perjury that I am(check 0110): <br /> O Legal property owner(owner Includes partner,trustee, taster,or corporate officer)of the property(s)Involved In this <br /> application,or <br /> O Lagal 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 tileoil their behalf.,and that tine foregoing application statements are true and correct. <br /> Print Name: V• %''( Signature: - Date <br /> Pn'nt Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> 10:0]NAP/LI,VB rw..y I.tYYp <br /> -4- <br />