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°AQUI" APPLICATION '- HOME OCCUPATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> q.--a�P BL APPL. NO: BL- <br /> ��KOR <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees <br /> from any claim, action or proceeding against the County arising from the Owner/Agent's project. <br /> I shall not employ any person other than a member of the resident family who resides on the premises. <br /> I, further, certify under penalty of perjury that I am (check one).- <br /> F1 <br /> ne):❑ 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: 1/ 1 nA Signature: Date: -JOPI <br /> Print Name: Signature: Date: <br /> STAFF USE ONLY <br /> G/P Designation: L Zoning: APN: <br /> DEPARTMENT APPROVED DENIED - DATE <br /> Development Services Planner Name: (A <br /> Building Inspection <br /> Fire District <br /> Environmental Health Div v' <br /> Public Works Department <br /> M.H.C.S.D. <br /> License Approved For: <br /> I <br /> Remarks: <br /> Accepted as Complete: Date: <br /> flapplications and handouUplanning forms/home occupation Page 4 of 4 <br /> (Revised 9-12-13) <br />