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LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZED SIGNATURES <br /> v u _ aRb* ���._' �.' ONLY 7HE OWNER OL THE PROPFR7Y OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION <br /> 11, the Owner/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 project. <br /> 1,further,certify under penalty of perjury that I am(check one): <br /> X Legal property owner(owner includes partner, trustee, trustor,or corporate officer)of the property(s)involved in this <br /> application,or <br /> Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and have <br /> been authorized to Erle on their behalf.,and that the foregoing application statements are true and correct <br /> Print Name: Signature: `1 ! 11 } Date: - y 41/ <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> -4- <br />