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h <br /> � aY <br /> � 1 <br /> APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> .;AUTHORIZATION:SIGNATURES <br /> <; ANAUHA , N..AOW2 ]YEYEMLEpFLiGRTiOY.. <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 /> I,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)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 /> Print Name: CJXV O-S -tSCWQ#H-- SignatureDate: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date, <br /> Print Name: Signature: Date: <br /> i <br /> i <br /> i <br /> s <br /> -4- <br />