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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 /> 1,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 I am(check one): <br /> )9 Legal property owner(owner includes partner,trustee,trustor,or corporate officer)of the property(s)involved in this <br /> application,or <br /> 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 /> Print Name: Se t2 2l./ f--1 5 F}FI? - Signature: it/��- Date:3116 () <br /> Print Name: 1 Signature: Date: <br /> Print Name: �u e e /. L 1( oc Signature: O Date: 3-Z G-CMZ <br /> Print Name: i` (��e �y r»eeR"'n Signature: Date: <br /> Print Name: Signature: Date: <br /> '1 � �K � � ' <br /> 2 Ot A--41'vb R i Z c Q( CLO)C+-�� �tj R 3-e- c� <br /> i> a p P 1 i C a:�i o y 0. CL �. <br /> _S_ <br />