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27,01 <br /> : a :-,PPLICATION — LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> : ; <br /> AUTH:ORIZATI4N SIGNATURES <br /> ©NLY THE..OWNER:OF THE PROPERTY ORGAN AUTHORIZED,AGENT.MA% -FILE-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 /> ® 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 /> Print Name: ED MACHADO FOR CIRCLE JM DAIRY Signature: Date: 2-Z--0 / <br /> Print Name: ED MACHADO, <br /> FOR CIRCLE JM PROPERTIES LLC Signature: 4��ALiDate: 2—fel— <br /> Print Name: 3 Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> FADEVSVMPlanning Application Forms\ Page 3 of 3 Job No 2007-228 LLA.doc <br /> Lot UneAdjustment,doc.(Revised 6-4-04) 6r"LSA <br />