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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: LLA- <br /> ' a <br /> � - �AI�THORIZED*�1`GEN�'-�M`i4Y„fl[E�ATj;gp_p�ICATION <br /> t I, the OwnerlAgent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> employees from any claim, action or proceeding against the Owner/Agent's project. <br /> f <br /> 1, further, certify under penalty of perjury that I am (check one): - <br /> p Legal property owner(owner includes partner, trustee, grantor,or corporate officer)of the property(s) involved in <br /> this application, or 1: <br /> .p Legal agent{attach proof of the owner's consent to the application of the properties involved in this application <br /> and have been authorized to file on their behalf and that the foregoing application statements are true and <br /> correct. pp tion <br /> Print Name: David! J. Brainlett <br /> Signature: �•• <br /> Print Name: Cindy K. BramlettDate: 05/17/2005 <br /> Signature: Date: 05/17/2008 <br /> Print Name; Thomas ILi <br /> .A t— <br /> Signature: <br /> Print Name: Date: 05/17/2005 <br /> Signature: <br /> Date: <br /> c <br /> t <br /> I <br /> r <br /> -4- <br />