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APPLIC,a nON— 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 /> I, the Owner/Agent agree, to defend,indemnify,and hold harmless the County and its agents,officers and <br /> employees from any claim,action,or proceeding against the Owner/Agent's project. <br /> 1,further,certify under penalty of perjury that 1 am(check one): <br /> X Legal property owner(owner includes partner,trustee,trustor,or corporate officer)of the property(s)involved <br /> in this application,or <br /> ❑ Legal agent(attach proof of the owner's consent to the application of the property's involved in this <br /> application and have been authorized to file on their behalf),and that the foregoing application statements are true <br /> and correct„� •, t <br /> Print Name: r r I-�!� �'d Signature: q Date: <br /> Print Name: Signature: Date: (Cj. ()/( <br /> Print Name: Signature: ;r - Date: °7- 0 <br /> illrPrint Name: G{ Signature: Date: <br /> Print Name: ishATr, lv. Signature: - Date: <br /> P:'S'COCtAT6N.1225p:fMfa4.n;�`:dpphtinur5ut+:livi>un.dtrc <br />