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r) <br /> oQ�u1d!v <br /> APPLICATION — L s� n OT LINE ADJUSTMENT <br /> � .. SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> AUTHORIZATION SIGNgTU:R'ES, <br /> QNii Y THE OWNER:OF-THE PROPERTY OR:AN:AUTHORIZED AGENT,-MAY FILE.AN APPfrICATlO <br /> f, the Owner/Agent agree, to defend, indemnify, and hold harmless the Count and ' N. <br /> employees #rom any claim, action or proceeding against the Owner/Agent's project. its agents, officers and <br /> f, 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 CfRCLE JM DAIRY Signature: / <br /> "- <br /> Print Name: ED MACHADO, Date: 4r-- <br /> FOR CIRCLE JM <br /> PROPER-p-c Signature: <br /> Print Name: Date:_ 7— <br /> Signature: Date: <br /> Print Name: Signature: <br /> Print Name; Date. <br /> Signature: <br /> Date: <br /> t <br /> I <br /> FADEVSVmPlanning Application Formsl Page 3 of 3 <br /> Lot Line Adjustmeat.doc.{Revised 6-4-04} Job No 2007-232 LLA.doc <br /> 14TH LLA <br />