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May- 19-00 10 . 45A <br /> P . 05 <br /> APPLICATION - MINOR SUBDIVISION <br /> SAN JOAOUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION.CIGNA T(/RF.0 <br /> _....-...._ ONLY THE OWNER OF THE PROPERTY GRAN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the OwneNAgont agree, to defend,Indemnify, and hold harmless the County and Ifs agents, officers and employees fr <br /> proceeding agalnat rho OwnerlAgent'a project om any claim, action or <br /> 1.further, certify under penalty of perjury that 1 am(check one): <br /> 0 Legal property owner(owner includes partner, trustee,trustor, or corporate officer)of the property(s)Involved in this <br /> application, or <br /> Logal agent(attach proof of the owner's consent to tho application of the pnopetry's lnvVlvrCl in thi,alrplicntiurt r�nJ <br /> have been authorized to file an their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: Ur K 51gnarure: Date: Z p <br /> Print Name: Signature: Date_ <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> MAY. 19 nn tFR T l 1 1 Gn •r n161 T r* T n �•. •• - <br />