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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTI-ioRIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY ORAN AUTHORIZED AGENT MAY FILE AN:APPLICATION. <br /> fl,th, Owner/Agent agree, to defend, Indemnify,and hold harmless the County and Its agents, officers and employees from any clalm, actlon <br /> oceeding 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 offFcer) of the property(s) Involved in <br /> this appllcatlon, or <br /> i <br /> Legal agent(attach proof of the owner's consent to the application of the property's Involved In this application <br /> and have been authorized to file on their behalf., and that the foregoln appllcatlon statements are true and <br /> correct. <br /> Print Name: Signature: <br /> 7-/ 7-� 7 <br /> it Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature: <br /> Date: <br /> i <br /> Print Name: <br /> i Signature: Date: <br /> Print Name: Signature: Date: <br />