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1 . <br /> L0 "LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> .AUTHORIZATION SIGNATURES <br /> ONLY? EOWNER. TNE.IPRGPERTYORANAUTHORIZEDAGENTMAYRLEAN APPLICATION. <br /> il,fhe OwnerlAgent agree,to defend,Indemnify,and hold h�mless the County and Its agents,ofi7cers and employees from any claim,action E <br /> Dr proceeding against Me Owner/Agent's project I� j <br /> 1,fuither, certify under penalty of perjury that 1 am(check pne): <br /> �Leal j <br /> property IIII { <br /> Legal p p rty owner(owner In partner,trustee,trustor,or corporate officer)of the property(a)Involved In thla <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 /> I' have been authorised to file on thflrbehalf.and that the foregoing application statements are true and correct <br /> I <br /> j <br /> Print Name: �4,eT0 i�fiS/ ` S G 1:: Signature: Date: <br /> i <br /> Print Name: Signature: Date: <br /> Print Name: A1;11 54Ae� Signature: � Date: 3--�;;�{ <br /> j � <br /> Print Name: Signature: Date: E <br /> Print Name: Signature: Date: <br /> E: <br /> s <br /> i <br /> i <br /> i <br /> r <br /> i <br /> i <br /> i <br /> i <br /> 1 <br /> I <br /> 1:41 PWA_LA99 Fehmwv t,19H <br /> -4- <br />