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LOT LINE ADJUST <br />� MENT <br /> SAN OAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE:OPM R.OF TN TY OR AN AUTHORIZED AGENT MAY RLE AN APPLICATION. <br /> 1,the OwneNAgent agree,to defend,IndemnW,and hold 14mless the County and Its agents,officers and employees from any claim,action <br /> or prioceedfng against the Own#A� gent's pmJecL P <br /> 1,fdfther, certify under penalty of perjury that 1 am(check�pne): <br /> Legal properly owner(owner ine�rvdes partner,trustee,trustor,or corporate officer)of the property(s)Involved In this <br /> application,or <br /> O Legal agent(attach proof ofthe era consent to the application of the property's Involved In this application and <br /> have been authorized to Ole on thilir behalf.,and that the foregoing application statements are true and correct <br /> 1• k, <br /> Print Name:-J * V-e-en. " SI /� -- <br /> :! l g nature: Date: / (1 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date, <br /> 'i <br /> i <br /> ' I <br /> i <br /> k <br /> t <br /> f J <br /> I i <br /> E f <br /> i <br /> i <br /> I <br /> r <br /> R <br /> 1:e1 PMPA_LA"Febm"1,1"2 <br /> -4- <br />