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--- -- _ APPLICATION-MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPM_E_NT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the Owner/Agent agree, to defend,Indemnify,sproject. end hold harmless the County and its agents,officers and employees from any claim,action or <br /> proceeding against the Owner/Agent's project. <br /> I further certify, under penalty of perjury,that!am(check one): <br /> gal <br /> Pro <br /> O e alar opeory owner(owner Includes partner,trustee,grantor,or corporate officer)of the property(s)Involved/n this <br /> O Legal agent(attach proof of the owners consent to the application of!re property's i,,vu,''ved In this application and <br /> -------------- <br /> have been cutharked to nie on their behalf,and that the foregoing application statements are true and correct. <br /> Print Name: / — 4�0�� , <br /> Signature a. <br /> Print Name: <br /> � <br /> ,Print Nwmw; Signature: Date. <br /> Print Nwirye! PAW"q/ ., 0 <br /> signature! 7 <br /> PrinfNamal Pa fel �'O� <br /> a/aortaturef <br /> Date. <br /> N IN/NSUOAYM Joum NLV. Y 10.61 (IND) <br /> -5- <br />