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LOT LINE ADJUSTMENT <br /> SAN JOAQuIN COUNTY COMMUIVITYDEVELOPMENT DEPARTMENT i <br /> i <br /> ON*1WE16YA ROFTNFPROP117TYOR'ANRtl7IlORf2FDAGLtJdTMAYI•TCI=AN IIAALICA7TOlif. <br /> 1,the Ownar/Agent agree,to defend,Indemnify,and hold harmless the County and its agents,officers and employees from any clalm,action or <br /> proceeding against the OwnedAgent's project <br /> 11 further, cerft under penalty of perjury that 1 am(check one): <br /> XLegal 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 authorked to file on their behalf.,and that the foregoing application statements are true and correct: <br /> Print Name: ,Ja G Signature: La Date: <br /> ; r <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> zow uMPAJAW rebw,,.,M <br /> -4- <br />