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LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAYFILE AN APPLICATION <br /> rE <br /> 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 1 am(check one): <br /> 0 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 <br /> have been authorized to file on their behalf.,and that the foregoing application statements are true and correct, <br /> f <br /> Print Name: Signature: i Date: : Get? <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> • I <br /> I <br /> i <br /> M <br />