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May- 19-00 10 _ 45A <br /> P _ 05 <br /> APPLICATION - MINOR SUBDIVISION <br /> SAN J04OUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATInN SICNATORF.0 <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED pQENT MA Y FILE AN APPLICATION. <br /> 1, (he Owner/Agont 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'a project. <br /> 1.further, certify under penalty of perjury that I 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 /> Legal agent(a Hach proof of the owner's consent to the application of the properry'5 Involvvu iri aria applicntiulr arrd <br /> have been authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: NL)C,I( /1")(^( A-II V N� 5lgnature: _ Date: <br /> Print Name. _ /a c,c?i) /i'7/)L2/ Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date. <br /> MAI'. 1 9 ' 00 (PFI) 11 :50 .COMMUNICATION No. 39 PAGE. 5 <br />