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APPLICATION-- SITE APPROVAL <br /> PRIVATE RIGHT OF WAY-ANTIQUATED 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 /> rl, theee, to defend,indemnify,and hold harmless the County and Its agents, officers and employees from any claim,action <br /> the Owner/Agent's project. <br /> , , er 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 this <br /> application, or <br /> 0 Legal agent(attach proof of the owner's consent to the application of the property's Involved In this application and <br /> have boon authorized to file on their behalf., and thatthe foregoing application statements are true and correct. <br /> Print Name: /JCJrJat f 1 �eZzzGfl1 - Signature: �Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> -s- <br />