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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 /> I further certify,under penalty of perjury,that I am(check one): <br /> Legal property owner(owner Includes partner, trustee, grantor,or corporate officer)of the properly(s)Involved In this <br /> application,or <br /> O Legal agent(attach proof of the owner's conaanf to th a It of the property's Involved In this application and <br /> /L1have(beeeen.`authorized to Ole on their behalf.,and"that the oing-!PBgaauomstatements are true and correct. <br /> Print Name: Signet Date.•-'� r/501 <br /> r <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> MINOR9VBI1lI It111111i V. X-1X-Ol 11X01 <br />