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USE PERMIT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> G <br /> ' xir�F 3 °it��C'a.tiZ,yGY� cry t tt ik° .� �n ,� rc4kYv° r ,}b3� }'SF' rn'� t x A <br /> �Y 3Y• 4 yi'y <br /> , aYALIT.HORIZATION_SIGNATURES , <br /> 4 'S�a"".7"A.4xa.y�'R3..vkvE4irl+it�'d� < r, ;r yixa"��y r�`�i1i � k49'r:�ft�4w ter,.: <br /> r kE, a y;rdla? t °ONLY THE OWNER,OFSTHE PROPERTY OR AN'AUTHORIZEDA GENT MAY,.% FILE AN 'APPLICATION. <br /> 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, <br /> officers and employees from any claim, action 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 <br /> officer) of the property(s) involved in this application, or <br /> o Legal agent(attach proof of the owner's consent to the application of the <br /> property's involved in this application and have been authorized to file on their <br /> behalf., and that the foregoing application statements are true and correct. <br /> Print Name: Karh✓ Irk ' _b19t�4 � Signature: l4,-( 2. 7� 4lq <-.tDate: 3ZO-ai <br /> i Print Name: Ce r e`=rate -SPc 1-e-to Signature: Date: <br /> Print Name: �c�t 6 CILLem Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> Print Name: Signature: Date: <br /> i <br />