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}_ <br /> APPLICA TION-MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZA77ON SIGNATURES <br /> ..ONLY THE'OWNER OF T14EPROPERTY.OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1,the OwnenAgent 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 /> l,.further, certify under penalty of perjury that 1 am(check one):` <br /> 0 Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s)Involved In this <br /> application,or <br /> 0 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 file on their behalf,and that the foregoing application statements are true and correct. <br /> Print Name: 22 /'�1�f� Slgnaturq: Date: <br /> Print Name: Signature: Date: <br /> Print-Name, dl netura:. : Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> a <br /> F <br /> j� <br /> 1 <br /> 2 <br /> f <br /> f <br /> • � .... .... -. ��f _ - .rte - _ ..- _ <br /> 7 <br /> I, <br /> ;1 <br /> MI11OA9VSgp4 FOAM ACV. B-10-OL (IHDJ <br />