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a <br /> APPLICATION _ MINOR SUBDIVISION <br /> SAN JOAQU.IN COUNTY COMMUNITY DEVEI~OPMENT DEPARTMENT <br /> AUTHORIZATION SIQNATURES <br /> ONLY THE pWNER OF TWPROPERTY OR AN AUTHORIZED AGENTMAY i 1LE AIV^ARPLICATION <br /> 1,the OwnerlAgent agree,to defend,Indemnify,and hold harmless the County and its agents, <br /> or proceeding against the Owner/Agent's project, ofi«cers and employees from any claim,action <br /> 1, further, certify under penalty of perjury that I am(check one): <br /> Legal property owner(owner Includes partner,trustee,trustor,or corporate officer of t <br /> this application,or 1 he property(s)Involved In <br /> 13 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 an their behalf.,and that the foregoin <br /> correct. g application statements are true and <br /> Print Name; <br /> Signature: <br /> Print Name: Date: a <br /> Signature: <br /> Print Name: Date: <br /> Signature; <br /> Print!Name: Date: <br /> Signature: <br /> Print Name: Date: <br /> Signature: <br /> Date: <br /> i <br /> I <br /> r <br />