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LOT LINE ADJUSTMENT <br /> AN JOAQUIN COUNTY COMMUNITYDEVELOPMENT DEPARTM,E;Nr <br /> :AUTHORIZATION s!ONATURES, <br /> : <br /> ONLY THE OWNER OF'THE PROPERTY R .- <br /> D ANAilTH <br /> ORIZEC AGENT 1L <br /> IifAYF tcANAPP�APPLICATION.' <br /> I <br /> .LIC T10 <br /> 1,the:OwnerlAgent agree,to defend,lndemnify,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 /> i <br /> 1,further, certify underpenalty of perjury that 1 am(check one): <br /> 1� Legal property owner(owner Includes partner,trustee,trustor,or corporate oHlce#)of the property(s)Involved In this <br /> I - r application,or <br /> t ' <br /> 0 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 file on their behalf.,and that the foregoing application statements are true and correct. <br /> i <br /> Print Name: <br /> ature: to. �'`�fn-fa0 <br /> u dF ` <br /> Print Name: 1 f�f � gnature Gtclate: r <br /> Print Name: <br /> n <br /> aru� r <br /> Dare: <br /> naturePrintName: twlZ _ Date: <br /> � <br /> PrintMName: Signature: Date: <br /> I <br /> I <br /> 4 <br /> i <br /> i <br /> I <br /> i <br /> I <br /> 1:41PUPA-L 93FeWuWy1,1M ! <br /> -4- <br /> r <br />