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USE PERMIT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> Ktlnu eish4af - .y. K <br /> +y�t"' ._. "_ ?t't1� • _' ? 'M*4yq�6��,P•LM" +� - <br /> _eOIVCYIE OWNER.OF,,:THE PROPERTYOR, l%T{fORiZEtTIHAY FILEFI-APPCIOTV.�<Ya. <br /> 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, <br /> officers and employees from any claim, action or 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 pariner, trustee, trustor, or corporate <br /> officer) of the property(s) involved in this application, or <br /> o Legal agent(attach proof of the owner's consent to the application of the <br /> property's involved in this application and have been authorized to file on their <br /> behalf., and that the foregoing application statements are true and correct. <br /> Print Name: I("V�j� fe}- a U 2--- Signature: p Date: 42,0>Print Name: Signature: Date:Print Name: RPh (Z Signatur Date: <br /> Print Name: Ch J Signature: �.._ - Date: <br /> Print Name: _ Signature: Date: <br />