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- - <br /> t JOB # 0275 <br /> APPLICATION <br /> SAN JOAQUIN COUNTY COMMUN <br /> tl'`( DEVELOPMENT DEPARTMENT <br /> a 'Y7n{,f�4rs.n>'13.r?rs.�,�Y�t�.��c.��ri�;�AUTNORfLA71at+1�SIlQ1flA7URH5a�,,� F+r � s �:'F�x >.ti... <br /> O <br /> ��.QVvt+lEfi�t7�TH�:�f�OPERTYQF7;4NAU'fFIQRtZ€r}'PiGE ThIA�FFIL�`,41kgAPP.L(CAT1oN„'^:z`��Y ,._..s. {” ,� ',�`^' <br /> 1, the OwneceadI Agent agree,to defend,tndemnlry,and hold harmfess the County and its agents,offlce�s and employees From any ciafm,action <br /> or proceedlnq against the OwnerlAgent's project <br /> I, further, certify under penalty or penury that t am(check onej. <br /> xLegal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the propenyls) Involved In <br /> this appllcatlon,or <br /> Legal agent(attach proof of the pwner's consent to the application of th4 PropertY3 <br /> and have been authorized to lite on their hehalr.,and that the foregoing application statements a eltrue and tion <br /> correct, <br /> Print Name: FRED FRANK <br /> Print Name: NANCY FRANK Signature: Data: <br /> Signature: Date. <br /> Print Name: jol <br /> SIgnature: Date: <br /> Print Blame: <br /> SIgnature: Date: <br /> Print Name: <br /> Signature, Date: <br /> i <br /> I <br /> f <br /> f <br /> 1 <br /> r <br /> y <br />