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APPLICATION - SITE APPROVAL <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZA.TIC?Al SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION <br /> I, 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 /> I, further, certify under penalty of perjury that I am (check one): <br /> Legal property owner(owner includes partner, trustee, trustor, or corporate officer) <br /> of the property(s) involved in this application, or <br /> Legal agent (attach proof of the owner's consent to the application) of the property(s) <br /> involved in this application and have ben authorized to file on their behalf, and that <br /> the forgoing application statements are true and correct. <br /> Print Name: Sandi de Jong Signature: Date: 21-Aug-03 <br /> Print Name: Frances de Jong Signature: Date: 21-Aug-03 <br /> Print Name: Brent de Jong Signature: Date: 21-Aug-03 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />