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r `N <br /> i <br /> APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> lliEilOf�1lf�i�tiilOtfllT•lAitiE ' <br /> . 0N CY.THE OWNER 06 7NE-PROPEEAi10NprtitAY.FILE'AIC APPUCAI"tON. <br /> I,the OwneriAgent agree,to defend,Indemnify,and hold harmless the County and iia agents,*Mears and employees from any claim,action <br /> or proceeding against the Owner/Agent's project. <br /> i <br /> i <br /> I, further, certify under penalty of perjury that I am(check one): <br /> 9 Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s) Involved In <br /> this application,or <br /> 0 Legal agent(attach proof of the owner's consant to the application of the property's Involved In this application <br /> and have Haan authorized to Ale on their behsK.,and that the foregoing application statements are true and <br /> correct. <br /> Print Name: Signature: ` Date: <br /> Print Name: Signature. Date: <br /> f <br /> Print Name: Signature: Date: at <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />