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ti <br /> r <br /> LOT LINE ADJUSTMENT <br /> SAN JOA UIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLYTHE OWNER OF TUE PROPERTY OR AN AUTN RI2'ED A ENT MAYFILE A N AP LIGATION. <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 l am(check one): <br /> xLegal property owner(owner includes partner,trustee,grantor,or corporate officer)of the property(s)involved in <br /> this 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 We on their behalf.,'and that the foregoing application statements are true and correct. <br /> Print Name: l ( 0nSignature: <br /> Print Name: 1 t! Signature.' <br /> Dafe: `-I —0-f <br /> .s <br /> Print Name: Signature: . Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> r <br />