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APPLICATION - MINOR SUBDIVISION <br /> SAN iOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORLZM AGENT MAY FILE AW:APPLIC'ATION. <br /> rengent agree,to defend,Indemnify,and hold harmless the County and its agents,officers and employees from any claim,action <br /> against the Owner/Agent's project. <br /> tify under penalty of perjury that I am(check one): i <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: �Lr[3�► J S ` E nPMAI AJ A� Signature: <br /> Date: <br /> Print Name: 1✓D� <br /> —s�.(j�P�,'yll4lW.. Signature: <br /> Print Name: Signature: v <br /> Date: <br /> IPrint Name: Signature: Date: <br /> Print Name: Signature: <br /> Date: i <br />