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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY ORAN 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 or <br /> proceeding against the Owner/Agent's project. <br /> 1, further, certify under penalty of perjury that 1 am(check one): <br /> /p 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 /> p N� ►gyp S' N�+I <br /> Print Name: {� l Signature: Date: — ?(S' <br /> Print Name: AL S . SpW RSignature: - Dater <br /> Print Name: H/l 12 7 1 T l� S r9/-/R/} Signature: b� �ci� ( SP Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> 5 <br />