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--� 0\ 4PPLICATION - <br /> � � � ) SAN JOAQUINCOUNT�OT � NE ADJUSTMENT <br /> ' DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN'AUTHORIZED-.AGENT MAY FILE AN APPLICATION. <br /> 1, 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 /> I, 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 I <br /> ❑ Legal agent (attach proof of the owner's consent to the application of the property's involved <br /> application and have been authorized to file on their behalf., and that the or going applia on st!7d <br /> are true and correct. <br /> Print Name; Tarlochan S. Grewal Trustee 7 �� / 'Signature: FG :. ; U ���Date: : <br /> Print Name: Gurbux K. Grewal Trustee Signature: 0 -CtYec� <br /> Date: c� <br /> Print Name: Ran'it S. Kaler Signature: <br /> Date:-2--.3---- <br /> Print Name: Nirmal'i K. Kaler Signature: ' <br /> Date. <br /> Print Name: <br /> Signature: Date: <br /> 4 <br /> F:TEVSVCSPIanning Application Formsl Page 3 of 3 <br /> Lot Line Adjustment-doc.(Revised 6-4-04) Job No 2006-132 LLA.doc <br />