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w I <br /> II <br /> S <br /> APPLICATION•MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> I AUTHORIZATION SIGNATURES <br /> ONL Y THE OyyNER OF THE PROPERTY 0 IAN AUTHORI2FD,AGENT MAY FILE <br /> M AN APPLICATION. <br /> 1,the OwneraAgent agree,to defend,Indemnity,and hold harmless the County and Its agents,officers and employees from any claim,action or <br /> Proceeding against the OwnereAgent's protect <br /> I <br /> I further certify,under penalty of perjury,that I am(check one): <br /> i I <br /> LegalProperty <br /> IIII g owner(owner Includes pa►tner,trustee,grantor,or corporate officer)of the property(A) <br /> application,or p perty(s)Involved in this <br /> 0 Legal agent(attach proof of the owner's consent to the application of the Property's Involved In this a llcatl <br /> have been authorized to file on their behalf.,and that the foregoing application statements are true and correct and <br /> Print Name: ` <br /> f Signature: <br /> Print Name: I Date: <br /> Signature: <br /> Print Name: Date <br /> ` Signature; <br /> print Name? Date: <br /> Print Memel signeturol <br /> paryr <br /> .,E, �Rlpn+rttrn: <br /> pate: <br /> ;I <br /> 'r <br /> I� <br /> I, <br /> 0 <br /> .I <br /> E <br /> II <br /> II <br /> a <br /> I� <br /> j <br /> I� <br /> y <br /> F <br /> it <br /> 1 ` <br /> , <br /> 1 <br /> M <br /> MINOR0URAPP MRM IREV. 0-10-01 (IND) <br /> -5- <br /> i <br />