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I <br /> = � IN LOT �.a`NE ADJUSTMENT <br /> 3. <br /> 7.' ? SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT I <br /> FILE NUMBER: <br /> I <br /> i <br /> AUTHORIZATION SIGNATURES <br /> I ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAYFILEANAPPLICATION. <br /> 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its a <br /> employees from any claim, action or proceeding against the Owner/Agent's project. gents, officers and <br /> I, further; certify under penalty of perjury that I am (check one I <br /> 1 � f' <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 1 <br /> are true and correct. <br /> E <br /> Print Name: David C. Per ' Trusteej <br /> Signature: Date:__ �y', <br /> Print Name: <br /> Mary Ann Perlr Trus#ee <br /> Signature: Date: <br /> Print!`fame: Reba A. Turnbull TrusteeSignature: <br /> �l f ';,`'�� ;. `�' <br /> rLt.C� 7.�.�'�A6,-Date: <br /> f Print Name: Barbara 5 Ne'ote Trustee <br /> Signature: Date. r <br /> Print Name: <br /> Signature: <br /> Date: i <br /> �3 <br /> i <br /> F,%DEVSVCIPlannwgApplication FormsV Page 4 Of 4 <br /> Lo(Late Adjustment-doc (Revised 6-4-04) Job No 2007-56 LLA,doc <br /> Il - <br />