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LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AU77IORIZAT70N SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICAT10N. <br /> I, 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 /> I, further, Certify under penalty of perjury that I am(check one): <br /> Legal property owner(owner includes partner, trustee, trustor,or corporate offrcer)of the property(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 rile on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: ! /lam Q 7�1� '�� ��A) Signature <br /> Date: 7��� <br /> DNf} Signature: Date: <br /> Print Name: 9 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> ' I <br /> 3 41 PMA• La9C FetM++ I.IN99 <br /> I <br />