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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 APPLICATION. <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 /> O 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. <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name. at nature: Deb: <br /> Print Name: 8/grbture: Date: <br /> Print Name signature: Date: <br /> .r'�r��e�J�onl ►� '� � roc, � �;� - -Lj <br /> dantf. Th. likkil V�. 4L� <br /> n - <br /> NI NOP9V94PP PQXN P[V. B-IP'�{ �IXO� <br /> -5- <br />