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�t R <br /> APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> 1 ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1,the Owner/Agent agree,to defend,indemnify,and hold harmless the County and its agents,ofcers and employees from any claim,action or <br /> proceeding against the Owner/Agent's project <br /> 1,further, certify under penalty of perjury that!am(check one): <br /> O Legal property owner(owner includes partner,trustee,trustor,or corporate officer)of the property(s)involved in this <br /> application,or <br /> i� <br /> O Legal agent(attach proof of the owner's consent to the app tion of the pr y's involved in this application and <br /> have been authorized to rile on their behalf.,and.that the for in applica ' st ements are true and correct. <br /> :1 <br /> Print Name: f1��"Signature: 1 ,117 Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature:. Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Y <br /> t ' <br /> . • r< 4 <br /> r <br /> f <br />