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LOT LINE ADJUSTMENT, <br /> SAN JdAQU1N COUNTY COMMUNITY DEVELOPMENT DEPARTMENTF' <br /> gUTHO1tlL4TlONSIGNATURES F� <br /> f ONLY TFtE 0"' PJ70pERTY,OR AN AUTHORIZED q Gktf A k,FILE AN APP06M7.0N. <br /> 1,the Geed r/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 protect f j - ' <br /> h 1,further, certify under penalty of pequry that I am(check ane): <br /> /[ 3 <br /> Lego!property awner,(owner includes partner <br /> application,or. ,trustee,trustor or corporate officer)of the property(s)involved in this <br /> O Legal agent(attach proof of the owner's consent to the application of the property's Involved In this application and <br /> have been authorized to Tie on their behalf,and thaf.the foregoing application statements are true and correct. <br /> Print Name: �-l�y� C. AS?�a TLl <br /> ` Signature <br /> Date: <br /> Print Name: red -�' -`-'�- <br /> �►"�"r Signature: <br /> Date: <br /> Print Name: . ------------- � <br /> Signature: <br /> is <br /> Print Name: Date: ---- <br /> Signature: Date: <br /> Print Name: �--�� <br /> Signature: <br /> Date: <br /> � yyb a <br /> r� i .YYn <br /> -- _x.94 � s �'�=T'?� �.ar.� • <br /> -n <br /> £ L / <br /> � t <br /> I <br />