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t <br /> f <br /> APPLICATION - MINOR 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 /> 1, the Owner/Agent agree, to defend,indemnify,and hold harmless the County and its agents,officers and employees from any claim,action or <br /> proceeding against the Owner/Agent's project <br /> I, further, certify under penalty of perjury that l am(check one): <br /> I� Legal 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 rile on their behalf.,and that the foregoing application statements are true and correct. � <br /> Print Name: j-0-ki—�&Oa'o Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> f Print Name: Signature: Date: <br /> E <br /> Print Name: Signature: Date: <br /> f I - <br /> l� <br /> I <br /> p <br /> I <br /> E <br /> lllif-.�-� acs:-•':,:��:,+�� .�-°"_,��.�.. -r—. -'".mow.�-%�a - - - .y.�.. �... ..c y .�,.� v. »'.s-.�_ ��.� . <br /> kE ! <br /> i <br />