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ZAf } 3 <br /> APPLICATION - MINOR SUBDIVISION <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!am(check one): <br /> O Legal properly owner(owner includes partner, trustee, trustor,or corporate officer)of the property(s)involved in this <br /> application,or <br /> 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 file on their behalf.,and that the foregoing application statements are true and correct. <br /> � GO <br /> Print Name: f V J / Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />{ Date: <br /> Print Name: Signature: Y <br /> Print Name: Signature: Date: p <br /> i t <br /> i <br /> i <br /> I <br /> a <br /> i <br /> ' 1 <br /> j <br /> I' <br /> -5- <br />