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APPLICATION - !MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APP(.ICATION. <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 /> I,further, certify underpenalty of perjury that I am(check one): <br /> 41 Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s)Involved in this <br /> application,or <br /> O 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 i <br /> i <br /> 1 <br /> Print Name: J�Vh E KE M A L. Signature. li��� Date: CAP <br /> Or <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: 1 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> i <br /> . y <br /> s <br /> F <br /> s <br /> -5- <br />