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APPLICATION - SITE APPROVAL <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELUPMEN I DEPARTMtN I <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 <br /> or proceeding against the Owner/Agent's project. <br /> 1,further, certify under penalty 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 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 file on their behalf.,and that the foregoing application statements are true and correct. <br /> /g/ y <br /> Print Name: pI,L /.,i Tr/� r� I Signature: �f // Date: Z— O' <br /> Print Name: ,,, IAA. .,k,'Gi r.W Signature: GCCL" (,.� Date: I <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> -s- <br />