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APPLICATION - MAJOR SUBDIVISION <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 /> FItheree, to defend,indemnify,and hold harmless the County and its agents,oFrcers and employees from any claim,action or <br /> e Owner/Agent's project. <br /> 1,further, certify underpenalty of perjury that I am(check one): <br /> o Legal property owner(owner includes partner,trustee,trustor,or corporate officer)of the property(s)involved in <br /> this 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 rile on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: ol <br /> ,S\-C f P 1 l0'�1 r tT�t ,Signature__, ate:J` - )O- <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> r,VMXR/MA /m.wrun21, 5=Dn P2 (W.10/20/0] iIDll <br /> -5- <br />