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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION, <br /> f, 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 Owner/Agent's project. <br /> 1, further, certify under penalfy of perjury that 1 am(check one): <br /> 0 Legal property owner(owner includes partner, trustee, trustor, or corporate officer)of the property(s)involved/a this <br /> application, or <br /> Legal agent(attach proof of the owner's 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: 2c." i a7 ` Signature: �_ Date: S C? <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Data: <br /> Print Narne: Signature: Date: <br /> -5- <br />