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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AILTHORtZ14TION"t3K3NATtJRES <br /> ... , <br /> `ONLY.THE'OWNER OF THE PROPt PROPERTY. OR AJWAEITFiORIZE! .AGENT MAY FILE AN APPl.1CATION.. <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 OwnerlAgent's project. <br /> I, further, certify under penalty of perjury that 1 am(check one): <br /> J� Legal property owner(owner includes partner,trustee,trustor,or corporate officer)of the property(s)involved in <br /> / \ this application,or <br /> Q 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: �OrL�C� //�j�yr�i�SU N Signature: Date: C /J <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> I <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />