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Mc PPLtC.AON - VARIANCE <br /> ,o �A A <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> BILE NUMBER:, VR- <br /> 77­ <br /> U N <br /> MEN <br /> g 1 <br /> M <br /> : . . The Variance will not authorise a use or activity which is not otherwise expressly eu77 <br /> thonzed by the zone regulation;governing <br /> `thepp"of prolioi�15- 17 <br /> pertjr , L, <br /> I <br /> o <br /> /�►UT7HC)R,IZA105N <br /> ONLY tH9TN�RiOIFlfi; PRIER 'O ,,AN;AI�THOf1ZD' '.lVl'i!Y,. ILE�► APLIC�► IQN <br /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees <br /> from any claim, action or proceeding against the Owner/Agent's project. <br /> I,further,certify under penalty of perjury that I am (check one): <br /> Legal property owner(owner includes partner,trustee, grantor, or corporate officer)of the property(s)involved in <br /> this application,.or <br /> E] Legat agent(attach proof of the owner's consent to the application of the property's involved in this application <br /> and have been authorized to file on their behalf., and that the f ing a anon state true and correct. <br /> e t ar <br /> Signature: Date: <br /> Print Name: r <br /> Signature: Date: <br /> Print Name: <br /> Print Name: <br /> Signature: Date: <br /> Print Name: <br /> Signature: Date: <br /> Print Name: <br /> Si nature: Date: <br /> - <br /> FADEVSMPlanning Application FormsWariance.doc.(Revised 8-18-04) Page 6 of 7 <br />