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H <br /> APPLICATION - MAJOR SUBDIVISION v <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> r <br /> I ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENTMAYFILE AN APPLICATION. <br /> I, the Owner/Agent agree, to defend,indemnify,and hold harmless the County and Its agents,officers and employees from any'claim,action or <br /> proceeding against the Owner/Agent's project. <br /> 1, further, certify underpenalty of perjury that i am(check one): <br /> o Legal property owner(ownerincludes partner,trustee,trustor,or corporate officer)of the proporty(s)involved in <br /> this application,or <br /> 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 /> f3'!�i✓l S 6 �'i 57/�T�S'�LL�'. 17 <br /> Print Name; rSignature: / Date; <br /> Print Name; Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name; Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> Fq.1d[7L6iv).➢A3 IKV.4/6/01 Sim] <br /> -5- <br />