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-N <br /> F � ; <br /> APPLICATION - LOT LINE j . <br /> I <br /> ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: LLA- <br /> -- � �AUTHORIZ,�ATION$1GiVAT � A x �`_ <br /> wONLY THt=OVI1NEFtrOFYT URt=S - <br /> �fE''P�OPERTY�;OR`AN;�►�iTJ;rpRIZ�DwAGEfifTMA1f�f=lLE-AN'APPLiCATiON.,,; <br /> 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> employees from any claim, action or proceedingagainst g the Owner/ <br /> Agent s project. . <br /> 1, further, certify under penalty of perjury that I am (check one): <br /> I� <br /> p Legal property owner(owner includes partner, trustee, grantor, or corporate officer of the roe ; <br /> this application, or ) P P rty(s) involved in <br /> i <br /> ❑ Legal agent (attach proof of the owner's consent to the application of the Properties <br /> and have been authorized to file on their behalf and that the foregoing application statements iareitrue alncdation <br /> correct. <br /> Print Name: Patricia Knowles . r <br /> Signator <br /> Print Name: Date: �d <br /> Signature: <br /> Print Name: Date: <br /> Signature: <br /> Date: <br /> Print Name: Da . <br /> Signature: i <br /> Date: <br /> 1 <br /> i <br /> i <br /> h <br /> i <br /> :7 <br /> Y <br /> -4- <br />