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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZED SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION <br /> 1, the Owner/Agent agree, to defend,indemnify, and hold harmless the County and its agents, officers and employees, from any claim, action <br /> or proceeding against the Owner/Agent's project. <br /> 1,further,certify under penalty of perjury that 1 am(check one). <br /> X 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 have <br /> been authorized to file on their behalf,and that the foregoing application statements are true and correct <br /> Print Name: STR NL F• R. RV A3,0 TSCAJ Signature: �� Ci 7/C+[v(. Date: 2 - <br /> Print <br /> -Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> -5- <br />