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APPLICATION - LOT LINE ADJIJSTIVIENT <br /> SAID JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> tl <br /> c l FILE NUMBER: <br /> F7 <br /> :v=... . � AUfiMATURES° > <br /> _gas <br /> ONLY THE bwmo,OF THE_PRQ? RTY GRAM)4UTHntIZE©AGENT:tUTAY i=1E,AN APPLICATION. <br /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> employees from any claim, action or proceeding against the Owner/Agent's project. <br /> I, further, certify under penalty of perjury that I am (check one): <br /> ® <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 /> APN 204-050-08, Delicato Vineyards <br /> i <br /> .J Print Name: &Eeez;;rL E Q14 Signature: �� Date: <br /> Print Name: Signature: Date: <br /> APN 204-050-09, San Bernabe Vineyards, LLC <br /> Print Name: L� l2c� i.1 flj- Ulm Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> d <br /> i <br /> F:\0EVSVC1Planning Application Formsl Page 3 of 3 Job No 2011-98 Lot Line Adjustment.doc <br /> Lot Line Adjustrnent.doc.(Revised 6A-04) <br /> i <br />