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°^• _'`1 i <br /> LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION <br /> 1,the OwnenAgent agree, to defend,indemnify,and hold harmless the County and its agents,officers,and employees from <br /> any claim,action,or proceeding against the Owner/Agent's project. <br /> 1,further,certify under penalty of perjury that 1 am(check one): <br /> dLegal property owner(owner includes partner,trustee,grantor,or corporate officer)of the property(s)involved in this <br /> application,or <br /> ❑ Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and <br /> have been authorized to file on their behalo,and that the foregoing application statements are true and correct <br /> Print N1 na ure: Date: <br /> Print Name: cC rc1[CJC�{?�(l1 ( Signatu �.� .���r Date: <br /> Print Name: C.t rN �i�{ QCs 11 Signatur . Date: <br /> Print Name( 1144.4,y 6 f` Signature:\�_ Date: — 1-b <br /> Print Name: �!/Ze I�. �a�� Signature: Date: 3 <br /> P15'f00KTONr,12285:00'.r!ncstl.=.�nl.o!linett�!j,�sv,ienLdoc <br /> J <br />