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APPLICATION - LOT LINE ADJUSTMENT <br /> _ a SAN JOAQUIN COUNTY COMMUNITY 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, 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 /> ® Legal property owner(owner includes partner, trustee, trustor, or corporate officer)of the property(s) <br /> involved in this application, or <br /> ❑ Legal agent(attaci 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 /> Lundblad Brothers,a Partnership <br /> Print Name: Richard Lundblad.Jr. Signature: Date: <br /> Print Name: Carl Lundblad Signature: Date: <br /> Print Name: Paul Lundblad Signature: C - �� p p`I Date: <br /> Print Name: Bethany Eve Lundblad King Signature:. j VJ�ld+.�y,)` i Date: —1— <br /> Print Name: Amy Marguerite Lundblad Signature: Date: R <br /> F%DEVWC1 Fann"Appficafion Fonnsl Page 3 of 3 Job No 2012-26 Lot Line Adjustment.doc <br /> Lot Line Adiustmentdoc.(Rinsed 64-00) <br />