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f <br /> APPLICATION -MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> atifHOFtiZATIOfV SIGNATURES <br />{, ONLY THE OWNER'OFTHE:PROI'ERTY OR 4fV AUTHORIZED IkGENT MItY FII,EAN APPLICATIOPf <br /> 1,the Owner/Agent agree,to defend,Indemnify,and hold harmless 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 /> x//// Legal property owner(owner includes partner,trustee,trustor,or corporate officer of the rn <br /> :his application,or p perty(s�involved In <br /> Q 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 flee on their behalf_,and that the foregoing application statements are true and <br /> correct. <br /> .l / <br /> Print Name: Signature: <br /> Date: <br /> Print Name: - <br /> Signature. Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature; <br /> Date: + <br /> 1 <br /> �I <br /> I <br /> I <br /> t <br /> 1 <br />