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APPLICATION - MAJOR SUBDIVISION W <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION 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 or <br /> proceeding against the Owner/Agent's project. <br /> 1, further, certify under penalty of perjury that I am(check one): <br /> o Legal property owner(owner Includes partner, trustee,trustor,or corporate officer)of the property(s)involved in <br /> this application,or <br /> a--, Legal agent(attach proof of the owner's consent to the application of the property's involved In this application and <br /> have been authorized to rile on their behalf.,and that the foregoing application statements are true and correct. <br /> f 'l <br /> Print Name; ,-A ko—IdZ 4r�1�,e!f %/G Signature: i Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> 4 <br /> 1 <br /> 1 <br /> wwacr�oxvuex �uv.vls/oi real <br /> 1 <br /> —5- <br /> 1 <br /> M <br />