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USE PERMIT <br /> SAN JOAQUIN COUNTY 00MMUNITYDEVELOPMENT DEPARTMENT <br /> S16NATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZEDAOENT MAY FILE AN APPLICATION. <br /> 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, <br /> officers and employees from any claim, action or proceeding against the Owner/Agent's project. <br /> 1, further, certify under penalty of perjury that I am (check one): <br /> o Legal property owner(owner includes partner, trustee, trustor, or corporate <br /> officer) of the property(s) involved in this application, or <br /> o Legal agent(attach proof of the owner's consent to the application of the <br /> property's involved in this application and have been authorized to file on their <br /> behalf., and that the foregoing application statements are true and correct. <br /> Print Name: �h�k � Signature: �/%Y+-�!r l�f Date:1rZ <br /> Print Name: l Signature: Date�2-10-o'c <br /> Print Name: k4x l YgAJQ it Signature: / y �/� 1 Date: 12-2216'1 <br /> Print Name: 04f129 (f/`��L11 Signature: ✓ Date: -Aa-eo <br /> Print Name: vXfC /� <br /> Signature: �j�f�eieG/ ( U Date: 12 23',1;.i/ /J <br />