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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHO R1ZATIOt+t SIGNATUR E 5 <br /> ONLY THE.OWNER OF THE PROPERTY OR AN:AUTFfOR AGENT MAY FILE AN APPLICATION. <br /> I,the Owner/Agent agree,to defend,Indemnify,and hold hartrtless 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 perjury that I am (check one): <br /> Legal property owner(owner includes partner,trustee,trustor,or corporate officer1 P P of the property(s)erty(s)involved in <br /> this application,or <br /> P <br /> O 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: RAYMOND 0 . BUTLER Signature: Date: �3 — 7,r <br /> Print Name: NANCY S . BUTLER Signature: ate: � 3 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: ! <br /> I <br /> I <br />