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4 • yfS <br /> APPLICATION - MAJOR SUBDIVISION <br /> k SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPE'R7Y OR AN AUTHORIZED AGENTMAY FILE AN APPL[CATION. <br /> 1,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 under penalty of perjury that l am(check one): <br /> o Legal properly owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s)involved!n <br /> this application,or <br /> o Legal agent(attach proof of the owners 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: � ` - <br /> Signature: Dater <br /> Print Name; <br /> Signature: Date: <br /> Print Name; <br /> Signature: Date: <br /> Print Name: <br /> t Signature: Date: <br /> Print Name: <br /> Signature: <br /> Date: <br /> 3 <br /> 1 <br /> t <br />