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LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> J <br /> L 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 /> r 1,further,'certify under penalty of perjury that l 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 file on their behalf.,and that the foregoing application statements are true and correct <br /> Print Name: _/ !l�� • Aia Sigsaturc: Date: <br /> Print Nh—: rj' �, Kia iu Ps Signature: Date: <br /> Print Name: 6rx !/(t' r'l Signature: C/� Date: <br /> Print Name: €, , Signature: 42�2� /`5- Date: - j -0 <br /> Pont Name: �irb rr-e-d r-' kr Signature: /tai Date: <br /> i <br /> J • <br /> 4 <br /> k <br /> F <br /> €t <br /> f <br /> _q_ <br />