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•+ LOT LINE ADJUSTMENT <br /> 5 <br /> 4 SAN JOAOUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AU7740WAMN SIGNATURES <br /> ONLY THE 0.WNM OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION_ <br /> 1,the OwnerlAgent agrees to defend,Indemnify,and hold harmless the County and its agents,officers and employees from any claim,action or <br /> proceeding against the Owner/Agents project <br /> 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 properly(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 We on their behalf.,and that the foregoing application statements are true and correct � <br /> Print Name: DANIEL ROCHA Signature: l ate: 9 Z j 3 <br /> Print Name: Signature: Date:r� ? 6 <br /> Print Name: JERRYROCHA Signature: Date:91AV <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> I, <br /> l <br /> f <br /> KIRKUBWAYOO OEM REV.2f1W <br />