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i <br /> eo <br /> I <br /> LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> qr� E <br /> _.< �;. .�-, '�:. �� -,k�fi° � �.��,"_.x "�}T � k�'h .'�'{�t k�di r� .`� 4'����:��Id+ o- ��"� `� F��'f'•t � +nl"5'� s� �;. <br /> 1, the Owner/Agent agree,to defend,indemnify,and hold harmless the County and irs agents,officers and employees,from any claim,action <br /> or proceeding against the Owner/Agent's project. <br /> i,further,certify under penalty of perjury that!am(check one): <br /> X Legal property owner(owner includes partner,trustee, trustor,or corporate officer)of the property(s)involved in this <br /> application,or <br /> I <br /> Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and have <br /> i <br /> been authorized to file on their behalf.,and that the foregoing application statements are true and correct 4 <br /> a <br /> Had <br /> � <br /> Print Name: Had S- J%0bef-+Aa n Signature: f� ��,0 <br /> Date: <br /> Print Name: �L�S �CeC� Signature: - <br /> Date: �2. �31 a <br /> Print Name: _BETTE ..8 L(,QC K Signature: <br /> Date: <br /> Print Name: Signature: Date: <br /> i <br /> Print Name: Signature: Date: <br /> I: <br /> i <br /> I <br /> .4- <br /> i <br /> i <br />