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t: <br /> y' 3 <br /> APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION'SIGNATURES <br /> ONLY THE OWNER OF THE:PROPERTY OR AN AUTHORIZEDAGENT MAY FILE AN:APPLICATION. <br /> 1,the Owner/Agent agree,to defend,Indemnity,and hold harmless the County and its agents,officers and employees from any claim,actlon <br /> 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)Involved In <br /> this application,or <br /> O Legal agent{attach proof of the owner's consent to the application of the property's involved in this application <br /> and have been authorized to file on their behalf.,and that the foregoing application statements are true and <br /> correct. <br /> Print Name: ,1 , .5GD,�j�� Signature: -_ _ �t�iyt.t.. �J� Date: 1 1 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> w <br /> I <br /> • f <br /> -5- <br /> r <br />