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+ APPLICATION - MINvR SUBDIVISION <br /> . SAN JOAQUIN COUNTY COMMUMTY DEVELOPMENT DEPARTMENT <br /> .-A <br /> Y S <br /> .. <br /> .,;QNtikid'4VNEl;<Cf :TH. <br /> rrlheecrie.4gent agree,to defend,Indemnity,and hold harmless the County and its agents,otticers and employees from any claim,action <br /> against the ownerlAgent's project. <br /> rtify under penalty of pedury that I am(check one): <br /> _ Legal property owner(owner includes partner,trustee,trustor,or corporate officer)of the property(s)Involved In <br /> this application,or <br /> 0 Legal agent(attach proof of the owner's consent to the application of the property's Involved in this application <br /> and have been authorized to file on their behalf.,and that the foregoing application statements are true and <br /> correct. <br /> j Print Name 5��� ��y�c� Signature: <br /> Date: 27" C3 <br /> Print Name: Signatur • Date: Z <br /> Print Name: �� h C 41 r S�y t SEgnature. 4 Date: '"! 7 <br /> Print Name: Signature: bate: <br /> Print Name: Signature: Date: <br /> l <br /> f <br /> k <br /> t <br /> I <br /> "S- <br />