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APPLICATION•MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY ORANAUTHORIZED AGENTIHAYFILEAN APPLICATION. <br /> I,the Owner/Agent agree,to defend,Indemnify,and hold harmless the County and Its agents,officers and employees from any clalm,actton or <br /> proceeding against the OwnenAgent's project. <br /> 1,further, certify under penalty of perjury that I am(check one): _ <br /> XLegal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s)Involved In this <br /> application,or <br /> O Legal agent(attach proof of the owner's consent to the application of the property's Involved In this application and <br /> have been authorized to f to on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: . JDYt a m LK I m Slgnaturo. Date: LT 2-- <br /> Print Name, Sl pMnatt rt Data: <br /> MntXame:. dIpMWI►r.,. ,�_�_ Dent <br /> Print Name! 4S pMWnI 'Data: <br /> Print Name! - S/ natun: Date: <br /> 1 <br /> MIMO�MV�rpyl 11iy, �q0-tl I1Y01 <br />