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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTNORIZATlON SIGNATURES <br /> ONLY THE OWNER OF THE PROPI:RrY OR AN AUTHORIZED AGENT MAYFILI: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 <br /> 1,further, certify under penalty ofperjury that t am(check one): <br /> XX Legal property owner(o wner Includes partner,trustee,trustor,or corporate officer)of the property(s)Involved In this <br /> application;or <br /> O 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 /> Print Name: Toni M. Raymus Signature: Date:f-19 Q1 r,' <br /> Print Name: Andrew Slaphos Signature: �: Date: -f/ <br /> Print Name: Signature: Date: <br /> loor <br /> Print Name: Signature: Date: <br /> Print Name:. Signature: Date: <br /> I <br /> 1 <br /> I <br /> -s- 1 <br /> 1 <br />