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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 /> 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 penalty of perjury that/am(check one): <br /> O Legal property owner(owner includes partner, trustee, trustor, or corporate officer)of the property(s)involved in this <br /> application, or <br /> O 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 /> i / J <br /> Print Namef'C ' Signature: ;/ c s< .c Icy_ Date: <br /> Print Name: h�:R { /� Signature: ��.� _� i��r�a^�!`, Date: <br /> / <br /> Print Name: :> <br /> _�_/�iL � �-% 1�C,/%S Signature: ( ��-p ".mac ��f�ti, Date: <br /> Print Name: Signature:- Date: <br /> Print Name: Signature: Date: <br />