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APPLICATION - SPECIAL PURPOSE PLAN <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 7fftheOwnerlAgent agree,to defend,indemnify,and hold harmless the County and its agents, officers and employees from any claim,action <br /> g against the Owner/Agent's protectrtify under penalty of perjury that 1 am(check one): <br /> O Legal property owner(owner includes partner,trustee,trustor,or corporate officer)of the property(s)Involved in this <br /> application, or <br /> 0 Legal agent(attach proof of the owner's consent to the application of the property's Involved in this application and <br /> have been authorized to File on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: ' Signature: Date: <br /> el< <br /> Print Name: m(a rid _ t "bis _ Signat e: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> _,.......:.gid <br /> -s- <br />