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r =� ��� •� �APPLICATION <br /> fig LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT D <br /> i c....�_. _ •P EPARTMENT <br /> ��Ra\ FILE NUMBER: <br /> - AUTH``4RIZATION�SIGNATURES <br /> I�NLY THE OWNER`�OF THE PROPERTY,OR AN:AUTHORIZED AGENT-MAY <br /> FILE AN AppLrcATION. <br /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, offi <br /> employees from any claim action or proceeding against the Owner/Agent's project. g cars and <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 involve <br /> d 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 /> Print Name: ED MACHADO FOR CIRCLE JM DAIRY Signature: <br /> Print Name: ED MAC HADO Date: a-� <br /> FOR CIRCLE JM PROPERTIES LLC Signature: <br /> bate. � — 6 <br /> Print Name: <br /> Signature: Date: <br /> Print Name; <br /> Signature: Date: <br /> Print Name: <br /> Signature: <br /> Date: <br /> F:\DEVSVC\Piannmg Application Forms\ <br /> Lot Line Adjustment.doc.(Revised 6-4-04) Page 3 of 3 Job No 2007-225 LLA.doc <br /> 3R°LLA <br />