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LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMONOY DEVELOPMEM C)1=PAR TMEN7 <br /> AUTHORIZED SIGNATURES <br /> ONLY:.THEOWNER Of 7HEPROPERTYORAN AUTPORIZED AGkNT MAY HLE: N APPLICA 13ON <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 /> 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 foregoin"ppl�ydn statements re true and correct <br /> p .J % <br /> Print Name: ��>� /C �T f�(J� �Sigaatur ... <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />