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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATlJRES <br /> 0fi1LY THE OWNER OF,Tkf PROPIrRTY QR 4iY.AU fHOf�iZ1=�.'A�EtVT NI,4Y Fl1»E,4NF.APPF:ICATiON' <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 /> 1,further, certify under penalty of perjury that I am(check onel: <br /> X Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s)involved in <br /> this application,or <br /> 0 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 file on theft behalf.;and that the foregoing application statements are true and <br /> correct. <br /> Print Name: �� Signator Gate: <br /> F Print Name:/�dS'�U.�i4LL f�J/ G.f Signature: - Date: ��z <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> t <br /> - I <br /> t <br />