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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> py p=Ortas?s GN SIGNATURES <br /> 0NLY'THE.OWN ER OF.7HE 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 <br /> or proceeding against the Owner/Agent's project. <br /> I,further, certifyunder enalty of perjury that I am(check one): <br /> Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s) Involved in <br /> this application,or <br /> O 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 on their behalf.,and that the foregoing application statements are true and <br /> correct. <br /> Print Name: <br /> qTh e� I VI e O e 0-1 Signature: U Date: <br /> AA,,LL -' - p <br /> Print Name: C cL �I)q nd Signature: �/'�- Date: �`'�� /Z <br /> Print Name: S Signature: Date: Z <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Ye <br /> .'__ / <br /> "41 — <br /> �77L <br />