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! LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUMORIZA770N SIoNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR ANAUTHORIZt:D AGENT MAY FILEAN APPUCA770N. <br /> Floth- <br /> 0 Owner/Agent agree,todefend,Indemnify,an <br /> oceeding d hold h4rmless the County and Its agents,otflaers and employees from any claim,acfJon <br /> orpriagainst the Owner/Agent's project if�I <br /> 1,further, certify under penalty of perjury that 1 am(check Ione): <br /> ' O Legal property owner(ownerincludes partner,trustee,trustor,orcorporate officer)of the property's)Involved In this <br /> application,or I <br /> O Legal agent(a Mach proof of the net's consent to the appUcadon of the property's Involved In this application and <br /> ' have been authorized to fife on thflr behalf.,and that the foregoing application statements are true and correct a <br /> u � <br /> Print Name: Signature: — Date: G�2 <br /> PtintName: s �nl C�_� �-YLL5fgnalure. Data: 1 <br /> Print flame: <br /> !. Signature: � Data: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> ;I <br /> 1 <br /> 1 <br /> a i <br /> , <br /> t <br /> h <br /> i <br /> i! <br /> N <br /> 4 <br /> i <br /> a� <br /> E <br /> 1.41 rurtiv,N Pebru"1.1M <br /> -4- <br /> 4 <br />