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T LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY 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 or <br /> proceeding against the Owner/Agent's project. <br /> 1,further, certify under penalty of perjury that I am(check one): <br /> • Legal property owner(owner includes partner,trustee, trustor,or corporate officer)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 have <br /> been authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: r_ r-e C e 1`i r-H Lk J0_] Signature: Date:3 l�S -' <br /> / / ,( <br /> Print Name: �L�L� �l. �"rJ(.�C' ` ' <br /> C7-06/c /— Signature: C ' " rK Ad Date:,, „( o;1- <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> 10:03 MAPA 1,88 F.b-,y 1,1888 <br />