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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AU,HORIZATION SA646th)RES` <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHfYR"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 <br /> from any claim, action or proceeding against the Owner/Agent's project. <br /> 1, further, certify under penalty of perjury that l 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 /> El Legal agent (attach proof of the owner's consent to the application) of the owner of the property(s) <br /> involved in this application and have been authorized to file on their behalf, and that the foregoing <br /> application statements are true and correct to the best of my knowledge and belief, <br /> Print Name: KenKje/dsen Signature: �j Date: -677- <br /> Print <br /> OZPrint Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name. Signature: Date: <br /> Print Name: Signature: Date: <br />