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APPLICA,riON - USE PERMIT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> -AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> I.. <br /> from any claim, action or proceeding against the Owner/Agent's project. <br /> I, further, certify under penalty of perjury that I am (check one): <br /> q, Legal property owner (owner includes partner, trustee, trustor, or corporate officer) <br /> of the property(s) involved in this application, or <br /> I Legal agent (attach proof of the owner's consent to the application of the property's <br /> involved in this application and have been authorized to file on their behalf., and that <br /> the foregoing application statements are true and correct. <br /> Print Name: .IACnIi SANC111'Z Signature: '� .a..1_-:w�._ z �� ���E' Dale: 08/01 /97 <br /> Print Name: Signature' Dale: <br /> Print Name: Signature: Date: <br /> LP,Jnte: Signature: Date: <br /> e: _ Signature: Date: <br />