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-- ATIQN -- LOT L,NE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> R� fiQR�, <br /> FILE NUMBER: <br /> AUTHORIZATION S'I.GNATURES <br /> ONLY THE OWNERrDF THE PROPERTY Q.R AN.AUTHORIZED AGENT MAY FILE.-AN <br /> 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its a APPLICATION.. <br /> employees from any claim, action or proceedingagainst t <br /> f <br /> g he Owner/Agent's project, gents, officers and <br /> !, further, certify under penalty of perjury that 1 am (check one)- <br /> ® Legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the prope s <br /> involved in this application, or p y{ ) <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 fi <br /> are true and correct. <br /> Print Name: ED MACHADO FOR CIRCLE JM DAIRY Signature: <br /> Print Name: ED MACHADO, i Date: — a <br /> FOR CIRCLE JM P.ROPERTIES LLC Signature: bate: Z,�` <br /> Print Name: <br /> . <br /> Signature: Date. <br /> Print Name: <br /> Signature: Date: <br /> Print Name: Signature: <br /> Date: <br /> I <br /> F;M EVSVCTlanning Application t=ormsl Page 3 of 3 <br /> Lot Line Adjustment.doc.(Revised 6-4-04) Job No 2007-224 LtA.doc <br /> 2Nn LLA <br />