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k <br /> APPLICA TION _ MINOR SUBDIVISION <br /> SAN Jpq 4lJIN COUNTY COMMUNITY DEVELppiy <br /> AUTyORIZATION SIGNATURES ARTMENT <br /> ONLY THE OWNER OF 7HE PROPERTY OR AN AUTHORIZED AGENT MAYFILE AN A <br /> I.the Owner/Agent agree, to defend,indemnify, <br /> proceeding against the Owner/Agent's ro PPLICATION. <br /> and hold harmless the County and its agents,officers and employees from <br /> P lett. <br /> 1,further, certify under penaity"Perjury that l am(check one). . <br /> any claim,action or <br /> Legal property owner(owner <br /> application, or includes partner, trustee,trustcorporate or, or cor I' <br /> officer)Erna propeny(s)involved in this <br /> O Legal agent(attach proof of the owner's consent to the application <br /> have been authorized to file on their behalf.,and that the fore <br /> goon the propert 's in <br /> Y <br /> going app volved In this application and <br /> Print Name: plication statements are true and correct <br /> X . <br /> Printez— <br /> Name: " �� Signature: <br /> Date: <br /> Print Name: - Signature: l �4 <br /> .pate: .� �.�.. <br /> Print Name: <br /> Signature: <br /> Print Name: <br /> signature: Date: <br /> .Signature: Date: ------- <br /> � <br /> i <br />