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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 O"OnAgent agree,to defend,Indemnify,and hold harmless the County and Its agents,officers and employees from any claim,action or <br /> proceeding against the OwnerlAgent's project. <br /> I further certify, under penalty of perjury,that I am(check one): <br /> 0 Legal property owner(owner Includes partner,trustee,grantor,or corporate officer)of the propeny(s)Involved in this <br /> application,or <br /> I <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 behaN.,and hat the foregoing application statements are true and correct. <br /> Print Name; 46t-l' I ZVOEZJ6 Signature: c,`L Date: 6/21e z_ <br /> Print Name: 1 natum- r Dale: <br /> Print Name: Nm: Date: <br /> Mint Namw eleraturnr natal <br /> Print Name: Iignafurol natal <br /> x�xoxavwrr ,wx ear. x io-m i�xo, <br /> _ -5- <br />