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I <br /> LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWWER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1,the Owner/Agent agree,to defend,lndemnlfy,and hold harmless the County and Its agents,officers and employees from any claim,action <br /> or proceeding against the Owner/Agent's project. <br /> i <br /> 1,further, certify under penalty of perjury that i am(check one): <br /> Legal 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 <br /> have been authorized to rile on their behalf.,and that the foregoing application statements are true and correct <br /> Print Name: R i L hQrJr-. Do e Signature: 7aj �J , / Date: /'/ <br /> Print Name., ci /y� . !� �F Z r <br /> Signature: 6, zz 2, Data: //-/5 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> r <br /> I <br /> 1A7 PWA LA"feWuny 1,1M - <br /> -4- <br />