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APPLICATION - SPECIAL PURPOSE PLAN <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ,`.22 <br /> �i �3}L,n.�'tbL.�p`^ of <br /> ONLY THE OWNS tiE�C�P�I�'S� Aft'At>�t��D� Y#� '�1t4k��11�1�CA't7tjN:_ <br /> SIGNATURE: I certify under penalty of perjury that I am (check one): <br /> L.-gal property owner (owner includes partner,trusses,trustor, or corporate officer) of the property(s) <br /> IX 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 beeii autho&-"to file on their`:9haff., and <br /> that the foregoing application statements are true and correct <br /> Cr✓{C n�c J`tu U�✓ per q. <br /> G <br /> 1 <br /> Signature- DOw <br /> Signature: Dtlm <br /> Signature: Dates <br /> Signature: Dale: <br /> Signature: <br /> —5— <br />