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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> o4<<xoR�''P• FILE NUMBER: <br /> AUTHORIZATION,SIG NATURES.. . <br /> ONLY THE OWNER_OF THE PROPERTY OR-AN AUTHO.RIZED_AG7T-uMAY:.FIiLE AN <br /> APPLICATION. <br /> 1, the Owner/Agent agree, to defend, indemnify, and hold harmless thenty andits 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 /> Print Name: ED MACHADO FOR CIRCLE JM DAIRY Signature: Date: <br /> Print Name: ED MACHADO, . ? // ; <br /> FOR CIRCLE JM PROPERTIES LLC Signature: Date: 2— —e- <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> k <br /> F TEVSVMPIanning Application rormsl Page 3 of 3 Jot)No 2007-229 LLA.dOG <br /> Lot Line Adjustment-doc.(Revised 6-4-04) 7TH LLA <br /> i� <br />