Laserfiche WebLink
USE PERK <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMEN'i <br /> � S.�tt ++;t .>,> ';a!: V r��� � ���`�''4i �2 i.� '1i3t i 3; .'�9 '§;h�f. Q � •{�" _ <br /> ACdTHORIZATIC?NSiGNATURES '.'<� ,�.�;. � � '�� .� r, <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, <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: �;('��n/a S /L(crn Signature: Date: 1 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />