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APP!_iCAI`iON - LOT Li PN1' 1 <br /> .,. I <br /> SAN JOAQUIN COUNTY COMMUNITY SE VFLOPfOLN i DEP;=,RI MENT' <br /> c . FILE NUMBED, <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> employees from any claim, action or proceeding against the Owner/Agent's project. <br /> 1, further, 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 this 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 have been authorized to file on their behalf., and that the foregoing application statements <br /> are true and correct. <br /> APN 009-160-04 <br /> William Ronald Berryhill and Trans Perez Berryhill,Trustees of the W&T Berryhill 1997 Revocable Trust under instrument <br /> dated 1/27/97 <br /> Print Name: William Ronald Berrvhill,Trustee Signature: `�7 <br /> Print Name: Triana Perez Berryhill,Trustee Signature: Date: <br /> APN 009-160-07; <br /> J& E Properties Incorporated <br /> Print Name: Jorge Eguiluz,President Signature: Af4hDate: <br /> PVOEVSVCNIannin9APplication FOrrns1 - Page 3 of 3 Job No 2017-70 LA <br /> Lot line Adjustrnemdoc.(Revised 64-04) <br />