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b <br /> f APPLICATION - SITE APPROVAL <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ... .. <br /> ' Tr' .. ...... :: <br /> !, the Owner/Agent agree, to defend, indemnify, and hold harmiess 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!am(check one): <br /> I <br /> ❑ Legal property owner(owner includes partner, trustee, trustor, or corporate officer)of the property(s) <br /> involved in this application, or <br /> 0 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: Ken Monroe Signature: Date.- <br /> Print Name: Signature: Date:. <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />