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rf <br /> APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES j <br /> r <br /> i <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION, <br /> i <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 1 am(check one): ; <br /> (L Legal property owner(owner includes partner, trustee, trustor, or corporate afticer)of the property(s)involved in this <br /> application,or <br /> 0 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 /> PrintName: e 5 ;�, Signature: , Date: <br /> Print Name: Signatu Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> r <br /> U <br />