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v <br /> LOT LINE ADJUSTMEW <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZED SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR 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 <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 foregoing application statements are true and correct <br /> Print Name: � / PItT 112AIX4AiL Signature: L"4re e BAP h/A Vt4r_,e/J Date: /D — 3D "d 2' <br /> rL i <br /> Print Name: ��r�V2i�� f� `, /4,I ro Signature: l��( ' -� r/4h s€� Date: <br /> N 4RWA r=if-WIity L"If�T/c,-, r1 <br /> Print Name: 'q R<I N PFI.SK;a /� Signature: / �l V'�l'Z L IVA iJ 4 IT KA Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> -4- <br />