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. a 6 APPLICATION - USE PERMIT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1 3 <br /> -..::......:...... ....:.::v... i :r.: .,:.:..:::::}:i:iiS::..:i'r".yy}:•;i;'a}:}i:i- -} ,( -..-....:......... - <br /> ..........r.n.n.,:....:5:;.}.. v:sv.:.i..::a:.v..hru..;.}'v,r:.n.:::r� ..v.kr.::.,..,:.:::f:•:.,vn'v vfi:::l�U ,n. .. SfS' ..ry.} <br /> �:.�::......... ......:.-...:::.r.. <br /> .3:.... :."f'�i� .r}mk, ..r.r.:%n.vi.}..r,,.r.]k,.:::�5}.:�:r::'{l::i :,•a-:.;;�'ii....v,},....{.. y:>.;:.t:;}} <br /> ...k.....o ...t............G.... .n:�.:•ra.';�::^o-:�A.`:a}:}^oar:;.;.z::;..;�.:..,}i..�.S.t.*o-.:[:'�. <br /> ..,:::..... \ }.:...:..::.v:nv.v::�::._::... 'Ss.. .:::-::.-.�....�.........' '. :� :. .?�.s. ..:•`.^:r!n.i:?}':' -:4r.,`i:•.<•'.::S.r{ ..jx?s` <br /> �::::_.:: ..:�::.:...::::: ..�..-..n':y:::'i.i::pi.a:nv,:•n.::;.v::tr;^Iry f <br /> ��:.�i:...::....:. .n...... ::v:.U.•:.v.v.}R..,y.:/:..:S.U:F.vn� i• r:}?ri�'vh�r =:.i'; ,��l x f !r$.. ..t�.. ..{. !U } <br /> ...:'�,:�:::k:.{.t.::.....r::.::::::.:i�::r<:::: :. }: --., ', �: ... .......... s::rffi:t?�:Y.i�^%�,i��.!::;:�+�:•:'•f.: , <br /> Al <br /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers.and <br /> employees from any claim, action or proceeding against the Owner/Agent's project.. g% <br /> is 1 <br /> I, further, certify under penalty of perjury that 1 am (check one): <br /> D Legal property owner(owner includes partner, trustee, trustor, or corporate officer) , <br /> of the property(s) involved In this application, or <br /> ® Legal agent(attach proof of the owner's consent to the application of the property's <br /> involved in this application and have been authorized to file on their behalf.;and that <br /> the foregoing application statements a e and correct. <br /> Print Name: T. WAYNE BOGART Signature: Date: 5-29—1 7 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> a <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> c t;g <br /> i <br /> C: <br /> 1 <br /> I <br />