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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 /> I,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 OwnerlAgent's project. - <br /> I, further, certify under penalty of perjury that I am(check one): <br /> 0 Legal property owner(owner Includes partner,trustee, trustor,or corporate officer)of the property(s)Involved In this <br /> application,or <br /> xLegal agent(attach proof of the owners 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 /> Print Name: �e �.lL`�I / Signature: Date: �¢" O Z <br /> Pdnt Name: Slpnature: Date: <br /> Print Namr: SI�Zurar. Data: <br /> Print Name: •S/pnature: Data: <br /> Print Nam a: SI nature: Date: <br />