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APPLICATION-MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY ORAN 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 OwneNAgent's project. <br /> 1 further certify, under penalty of perjury, that 1 am(check one): <br /> O Legal property owner(owner includes partner, trustee,grantor, or corporate officer)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 <br /> been authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name:��-(/f-t/V !cJ C Signatures Date: <br /> Print Name: - Signatu Date: ! <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> IAINORSVNAPP FOAM 0.EV. B-IO-OI IIIIN <br /> -5- <br />