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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 /> 1, further, certify under 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 /> O Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and <br /> have <br /> been(authhorized to file on their behalf.,/and that the foregoing application statements are true and correct. <br /> Print Name: ![�ti' YV I Uu-p-I I Signature: -s r/ 2�"� Date: I /I �' Z <br /> Print Nmc Signature: Date: <br /> Print Nstama: ->hrW r Signature: Dib: <br /> Print Name; Signature: Date: <br /> Print Nams: SI nature: Date: <br /> nlxol,avMet roM xev. aq0-ol Itxnl <br />