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f <br /> APPLICATION MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> . :. ;. .. 'AUTHORl2i4T10N SIGNRTURES '. <br /> ONLYTHE:OWNEA aF THE:PROPERTY 017 N"AUTHO IZED.AGENT:141AY.FILIS aN.ApMICATI0M1f <br /> i,the Owner/Agent agree,to defend,indemnify,and hold harmless the County and its agents,officers and employees from any claim,action <br /> or proceeding against the Owner/Agent's project. <br /> I,further, certify under penalty of pejury that 1 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 /> ❑ 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 /> Print Name: C- �" /' <br /> Signature• , � �. Date• <br /> I 6 <br /> Print Name: Signature: Date: ! 2sy <br /> i <br /> Print Name: L,-)*1 r,J Signature: / Date: rZ-3-� <br /> Print Name: Signature: ;� u.��7�'1 Lli_Z�7� cx�•`_ , pate: S <br /> Print Name: Signature: Date: <br /> i <br /> II <br /> i <br /> i <br /> t <br /> i <br /> I <br /> I y� <br /> s <br /> ( <br /> -4- ,.� <br />