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.39/23/2005 @8:15 20933426 1 MONTE SEIBEL PAGE 01 <br /> sn <br /> tAPPLICATION -- LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> +. FILE NUMBER: <br /> AU"T"HORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AlJ1'HORIZEO AGENT MAY FILE AN APPLICATION. <br /> I, the Owner/Agent agree, to defend. Indemnify, and hold harmlass the County and its agents, officers and <br /> employees from any Claim, action or proceWing against the Owner/Agent's project. <br /> 1, further, certify under penalty of penury that I am (check one): <br /> XLegal propel owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> InVolved in this applkaWn, or <br /> ❑ Legat a ent(:attach proof of the owner's consent to the application of the propertys involved In this <br /> application and have been autliorixed to file on their behalf,and tiont the foregoing application statements <br /> are true and coed. <br /> Pr"Name: Al I�CHh';)b - Sigrntuna: pate. 09 d <br /> Print Name: v ' � Signaturo: DM <br /> Print Name: 1 C Signetrx�: Date: <br /> PnrK Name: !!�f� �-C-- .._ Sipr> b"'. Da <br /> Print Name: ._ ,,. Vgnatura: Date: <br /> I <br /> F:0EVSVCUM4A"Appkmdan hive Page 5 of 7 <br /> LA Low Aon#w.W-OWA"O"44) <br /> I <br />