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LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZA TION SIGNA TURES <br /> ONLYTNEOWNER OFTHE PROPERTY ORANAUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I,tiro Owner/Agent agree,to defend,indemnity,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 /> O Legal property owner(owner includes partner,trustee, trustor,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 properly's Involved In this application and <br /> have been authorized to We on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Narve: <br /> S':�,:nature: <br /> Print Signatur <br /> Datta: <br />'F Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> i <br /> i <br /> f <br /> 1:4t PMPA-LA9E February 1,7999 <br /> -4- <br />