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q <br /> z LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION siGNAruRES <br /> ONLY THE OWNER OF TWPROPERTY OR AN AUTHORIZED AGENT'MAY FILE AN APPLICATION. <br /> 1, 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 /> #.y O Legal property owner(owner includes partner, trustee, trustor,or corporate officer)of the property(s)Involved In this <br /> y application,or <br /> Legal agent(attach proof of the owner's consent to the application of the property's Involved In this application and r <br /> have been authorized to fife on their behalf.,and that the foregoing application statements are true and correct. <br /> 6..I Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> U <br /> �. Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> � Print Name:; Signature: Date: <br /> k . <br /> x RI <br /> ' I i <br /> yf` <br /> .1' 3 <br /> r <br /> i <br /> lµ4 I I• <br /> r <br /> i <br /> r f <br />,g, '} <br /> 1;/1 PAIPkLA98 Fewom 1,1099 - <br />