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APPLICATION <br /> SAN JOAQUIN COUNT`(COMMUNITY DEVELOPMENT DEPARTMENT <br /> ? h i} ,;srvi! s �, s ., .4v��'kfj2ti::S.>$`'t':f?.'':'',�':£�s i• w ,,,tsar cs .;:c,:r".v: ',::c:';.%.ok''t":.::•.:: <br /> �' ^.,, s(� *, J��' z �4E3'sAt?T}iORtZAT10NSlfl ATURt=S <br /> a33ty,..t t,r,}3 'tSot".. eel•'Io-1J.�`k't�' <br /> .": , .'.••' ^',:•.w• >'"�>••<bN�Y<�ii1=.OWNEROFX")Hi<'pROPER O AhAI�A��O�EBjAGE%NT.hi,4��Flt`:E'i4T��APYPI�I A7lQN�.>hy;Ya�°Giea'>�''�.��Ri�i� 'C� <br /> 1, the OwnerfAgerrt agree,to defend,Indemnify,and hold harmless the county and Its agents,offlceys and employees from any claim,anion <br /> or proceedIny against the Owner/Agent's projecL <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 <br /> this application,or. <br /> ❑ 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 their behalf.,and that the foregoing application statements are true and <br /> correct. <br /> Print Name: ��/ �-�27SIgnature: <br /> ` Date: -�4 ©� <br /> Print Name: ���� C_ c� ;T t HCC w <br /> Signature: �--� �.- ... <br /> Date: <br /> Print Name: <br /> Signature: Date: <br /> Print Name: <br /> Signature: Date: <br /> Print Name: Signature: <br /> (?ate: <br />