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-JT LINE ADJUSTMENT <br /> :1371,77 . <br /> SANJOAQUINCOUNTYCaMMUN1TYDEVELOPMENT DEPARTMENT <br /> Al1T1IOR12ATION NA R- . <br /> - t. .:`? �_.GN4Y�'llEOWN�RGF7Fl�PROPE. ;..: <br /> RTroR.divAUrlvcRlzEa.4G�NrM.4'YFICE au APPLIC,4rroN. <br /> i f,the Owner/Agent agree,to defend,lndemnlfy,and hold harmless the County and Its agents,officers and employees from <br /> Proceeding against the Owner/Agany claim,action or <br /> ent's project <br /> t 1,further, certify under penalty of perjury that!am(check one): <br /> 0 Legal property owner(owner includes partner,trustee, <br /> application,or trustor, or corporate officer)of the property(s)Involved In this <br />� <br /> Legal agent(attach proof of the owner's consent to the application of the ro a <br /> rtyrs In this ap <br /> been authorized to file on their behalf.,and that the foregoing application lication sta ementsinvolved are true and correcGcatlon and have <br /> Print Name: (,��v <br /> Signature: Date: 13 D� <br /> Print Name: f <br /> Signature: <br /> Print Name: Date: <br /> Signature; <br /> Print Name: <br /> Date; <br /> Signature: <br /> Print Name: <br /> Date: <br /> Signature: Date: " <br /> .E <br /> I <br /> Y <br /> t <br /> 10:07 AMPA IRAN Fvb ,1,1888 <br /> -4- <br />