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` PC•UIN. <br /> h ' c "rAPPLICATION — LOT L NE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> Q�iFaP'` FILE NUMBER: <br /> AUTHORIZATION SIGNATURES. <br /> 7ONLYE OWNER OF THE PROPERTY ORANAUTHORIZED AGENT,MAY FILE:AN APPLICATION. <br /> , teOwner/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 /> 0 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: Tarlochan S. Grewal Trustee Signature: /'' Date: 6 6` <br /> Print Name: Gurbux K.Grewal,Trustee Signature: i Y KA el X k• Date: .3 —f,S b <br /> Print Name: Raniit S. Kaler Signature: IeZ4 a�t_��Z��_ Date: .( �8 <br /> Print Name: Nirmaijit K. Kaler Signature: 1�" /� ��� Date: 3, <br /> — — <br /> A 4 <br /> Print Name: Mary H. Brawley,Trustee Signature. i1-1 <br /> Date: �p <br /> Print Name: David J. Brawim Trustee. Signature: Date: 3 <br /> Print Name: Juanita Z.Garcia Signature: . Date: oma( 'D <br /> Print Name: Martin A. Garcia Signature: ` a_ Date: {r � <br /> I <br /> FMFVSVC\Planning Application Formsl: Page 3 of 3 Job No 2005-280 <br /> Lot Line Adjustment.doc.(Revised 6-4-04) <br />