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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT _ <br /> AUTHORIZATION SIGNATURES Il <br /> ONLY THE.CWNER OF T]iE PROPERTY GRAN AURHO R=*AGENT MAY FILE AN APPUCATICN.. <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, certify under penalty 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 /> 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 /> I <br /> Print Name: ���1�fi'1 �I 1 �)`11�1�,li�� Signature: s= Date: <br /> AJA/ <br /> Print Name: Signature: Date: <br /> i <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> 1 <br />