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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> SIGNATURES: <br /> ONLYIHEOWNER -T.yi'oFt:AN:-AU.THORaEU-AGEW.:MAY TLE AN APPLICAT10h <br /> � .THE <br /> 1,the OwnerlAgent agree,to defend,Indemnity,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 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 /> 0 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: Signature: <br /> Date: Jam-r7 <br /> Print Name: 141-&5K rA <�;/lit.1,117 e.r- Signature: X Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Date: <br /> Print Name: Signature: <br />