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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMEN- <br /> FILE NUMBER: <br /> AUTHORIZATION SIGNATURES <br /> it ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> me Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers arc; <br /> --npioyees from any claim, action or proceeding against the Owner/Agent's project. <br /> `urther, certify under penalty of perjury that I am (check one): <br /> Legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> involved in -his application, or <br /> _ Legal agent (attach proof of the owner's consent to the application of the property's involved in this <br /> application and nave been authorized to file on their behalf., and that the foregoing application statemer.'tS <br /> are true and correct. <br /> __ndblad Brothers,a Partnership <br /> ni Name: _ Signature: Dare: _ <br /> = et Name: Richard Lundblad,Jr. Signature: e .,.,p`, rti ,d, Date: <br /> -.nt Name: Carl Landbiad Signature: — <br /> rt Name: Paul Lundblad Signature: <br /> gin: Name: Bethany Eve Lundblad Kina Signatures 1�Q oh4 ,ti(�„`M Date: <br /> 'o: Name: Amy Marguerite Lundblad Signature: ate: <br /> =vSvo,P:annmg Appiicaton Forms\ Page 3 of 3 Job No 201'-154 Lot Line Adjustmen .dc.; <br /> ,z,Aqu=_:nent doe (Revised 8-404) <br />