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. G <br /> L04 LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNfry DEYELOpMENT DEPARTMENT <br /> ALrTHMZAIM 302NA7UFtft <br /> ONtY7HEDWHD�0IC-TNEPA+�CWANAuTmoRawAdeiruAymffi ow AppucCrxw- <br /> I,the OwnaNAgwd agree,to defetxl,kxkmn!&,and hold harmless the County and Its agents,otllcers and em PI !'o <br /> proceeding against the Owtm7'AgwWs pr*a ares fiam any clalrrr,action or <br /> 1,further, card&undar penalty of pedury that I am(check one): <br /> 0 Legal propety owner(owner includes parWer,dusted trustor,or cw wrote ofdcerJ of the propwty(s)Involved In this <br /> appllcadom or <br /> 0 Lagd agent(attach proof Of the owner's consent to the appllcadlon of the property's Involved in this application and have <br /> bean auMorbed to Me on their behalf.,and that the tcroWng appllcatlon statements are tnw and corroct <br /> EIGENBERGER DEVELOPMENT <br /> Print Name: ADAM EIGENBERGER Signature: Date. fo <br /> ROBE ' <br /> Print Name. RT DELL ARINGA <br /> Signature: <br /> Print Name: Signature: <br /> kl�� Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Slgnaturv: <br /> Data: <br /> i <br /> i <br /> +am MwtiuM Feb,-j I.iaaa <br />