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L T LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY ORAN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1,the Owner/Agent agree,to defend,Indemnify,and hold harmless the County and Its agents,officers and employees from any claim,action or <br /> proceeding against the Owner/Agent's project. <br /> 1,further, certify under penalty of perjury that I am(check one): <br /> O 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 have <br /> been authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: n1N1r T Y1 Signature: Date: <br /> PrintName: RLY}t 'C ` �� Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />