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SU/MS (MH) <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT1DEPARTMENT <br /> r <br /> ,.,. <br /> AUTHORIZ�4TION,SIGNATURS <br /> ONtY'THE OWNER OFFTHE PROPER7' 6R AN A' U 7, OR/ZED 4GENTMA`Y FILE 4N A L 1 `ATIQN ''sa <br /> 1,the OwnerfAgent agree,to defend,Indemnify,and hold harmless the County and Its agents,officers and employees from any claim, <br /> action or proceeding against the Owner/Agent's project. <br /> 1,further, certify under penalty of perjury that I am(check one): <br /> ❑ Legal property owner(owner includes partner,trustee, trustor,or corporate officer)of the property(s) <br /> Involved in this application,or <br /> ® Legal agent(attach proof of the owner's consent to the application of the property's Involved in this <br /> application and have been authorized to file on their behalf) <br /> and that the foregoing application statements are true and correct. <br /> Print Name: ERIC TEED-BOSE Signature: Date: <br /> Print Name: Signatu Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> P:Mountain House/MH Application FormsiMH-Subdivision SU-MS Form <br /> -9- <br />