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APPLICATION - USE PERMIT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> rii: x r.. } + s.- - >-.k• #: .r k < .f #',#.,#;5 r'.3xtk°St% }» ¢, kT1 <br /> :t. ..:...... AUTHOR17-A <br /> TION SIGNATURES�> ...:...:......} .....:.-:.: <br /> :..........;.............:......................... .. .. ..........,,............ <br /> - s s-> u t�#�-. -r>',..` t - - +:#�` -->i 4 r..r.y�$«- 3 S: F - ' <y 5 £ s}�k5a}fi''2t5 S <br /> ?S -°> ? :t:,�w: ;:<'ok.�ktikk2<..,,<S uSf «<:>;,<,. <.#:;i;t#;;:e#. 2k,<is; :e,;E k�t.#le,"##'ae#2#:if•+,i ;£kEi:'t#`�°��„est f#. �az33:;z :kf}z -#F#4� BRIM, <br /> 5'# 55 <br /> v`, >? x 5 aNI.Y 7NE OWNER O TFiE 2QPEi2T1f OR At+l AU7i�oRrlEA AGENT mAY FILE AN APPIJCATIow a ' <br /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> employees from any claim, action or proceeding against the Owner/Agent's project. <br /> I <br /> I, further, certify under penalty of perjury that 1 am (check one): <br /> o Legal property owner towner includes partner, trustee, trustor, or corporate officer) <br /> of the property(s) involved in this application, or <br /> o Legal agent(attach proof of the owner's consent to the application of the property's <br /> involved in this application and have been authoriz d t it their behalf., and that the <br /> foregoing application statements are true and co <br /> or <br /> Print Name: Robert D. Torres Signature: Date: <br /> VP of Operations <br /> Print Name: Signature: Date: <br /> �ZA—#I <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br />