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LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIL4TION SIGNATURES "` <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN'APPLICATION. <br /> 1,the Owner/Agent agree,to defend,lndemnlfy,'and hold harmless the County.and Its agents,'officers and employees from any claim,action <br /> or proceeding against the OwnedAgenrs project <br /> !, <br /> further, certify under penalty of perjury that./am(check one); ,F <br /> Legal property owner(owner Includes partner, trustee,trustor,or corporate officer)of the properly(s)Involved In this <br /> ` application,or <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 f le on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Nalene: _ (G�1/.�j"� 1C7 �� �7� Signature: Date: 7 <br /> Print NalIene: ! Signature:. Date: $ <br /> Print Name: Signature: Date: <br /> ` I ! <br /> Print Name: 8 Signature: Date.- <br /> MIN <br /> ate:Print Name: Signature:. �� Date: <br /> E� l ii <br /> :r <br /> �i <br /> r <br />