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SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT D UMSTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THEPROPERTYORANAUTHORIWDAGENTMAYFILEAN APPLICATION. <br /> 1,Ne Owner/Agent agree,to defend,Indemnify,and hold harmless Ne County and its agents,-f fcera and employees from any claim, <br /> action or proceeding against Ne Own/Agent's proiacL <br /> 1,hurtful, certify—u/ntlerpenaltyo/perjurythatlem(checkone): <br /> }f Legal property owner(Owner includes partnerftu.tea,trvstor,orcorporate c/ficer)ol Ne property(sJ <br /> involved In this application,or <br /> ❑ Legal a9ent(attach proo/o/the owner's consent to the application of Ne property's Involved/n this <br /> application and have been auNorlred W file on theh behaln <br /> and that the foregoing application statements are We and correct <br /> Print Name: �'v tN SC1YG-SVvs Signature: ' - Data: 2rI7IIS <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FlkM Main Ho .s ppliv nFor sWH-SuWivWk nSM-MSFImmMA MR.dm + <br />