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USE PERMIT <br /> SAN JOA QUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES z <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, <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 1 am (check one): <br /> d <br /> j n Legal property owner(owner includes partner, trustee, trustor, or corporate <br /> ' officer) of the property(s) involved in this application, or <br /> j % Legal agent (attach proof of the owner's consent to the application of the <br /> i 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: PAUL E . VAZ , JR. SignatllretG� � ! ' ' ,�.f /� Date: •- <br /> Print Name: PtIILLIP G , VAZ Signat4/e. A: ' ( I�� -WDate: % >' <br /> Print Name: PETER R.VAZ Signature'• �! �.' (d trDate: .'.�' <br /> Print Name: PERRY 3 . VAZ Signature: SLC' � t .; �C ��!:.'/!� Date. �.. <br /> Print Name: _ Signature: Date: <br />