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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT <br /> DEPARTMENT <br /> ONLL YTH E EKQ#�-Txt <br /> A t APPLICATION <br /> 1,the owner/Agent agree,to defend,indemnify,and hold ttarmlesi the County and Its agents,officers and employees from any claim,action <br /> or proceeding against the OwnerfAgent's project.�, <br /> 1,further, certify under penalty of perjury that I am(check one): <br /> Legal property owner{owner Includes partner,trustee,trustor,or corporate officer)of the property(s)Involved In <br /> this application,or <br /> 0 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 /> P rl nt Name: YL&) Signature:1)4e1.bZe--LP Date: <br /> Print Name: ---------------- Signature: <br /> Date: <br /> Print Name: <br /> Signature: Date: <br /> Print Name: <br /> 'in'Name, Signature. Date: <br /> Print Name: <br /> Signature: Date: <br />