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.I <br /> LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT'DEPARTMENT' <br /> .AUTN0RftA710N SIGNATURES <br /> ONLY THE-OWNER:.07 x?fE.AROPERTYORANAWWORCEDAGENT AMYFILEAN APPLlCA170Nf. <br /> 1, the Owner/Agent agree,to defend,lndemnlly,and hold h less the County and Its agents,officers and employees from any claim,action <br /> w or proceeding against the Owner/Agents project 1 <br /> 1, hirther, certify under penalty of perjury that 1 am(check <br /> O Legal property owner(owner Indudes partner,trustee, trustor,or corporate officer)of the property(s)Involved In this <br /> F application,or �Oes <br /> O Legal agent(attach piioof of the consent to the application of the property's Involved In this application and <br /> have been authorlred to R!e on th fir behalf„and that the foregoing application statements are true and correct. <br /> k It <br /> i <br /> Print Name: ; 5lg --_ <br /> nature: <br /> Prin#Name: U �� Signature: Date: DZ <br /> Print Name. Signature: <br /> Date: <br /> Print Name: Signature: Date: _ <br /> Print Name: Signature: Data: <br /> k <br /> i <br /> i <br /> I . <br /> E <br /> i <br /> I <br /> I <br /> 1:41 PWIPAtw66 FaMuyr 1,1666 " <br /> -q- <br /> Y <br />