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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 <br /> penalty of perjury,that I am(check one): <br /> y Legal property owner(owner Includes partner,trustee,grantor,or corporate officer)of the property(s)involved in this <br /> application,or <br /> P 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 Me on thee;behalf,and that the fors o!ng application statements are true and correct. <br /> Print Name: a 12 Tu uY- 14-,6,&LC Slgnatur . / Date: �' �6 'off <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Nemer ilgneturer Dater <br /> Print Nam*, Signature+ pater <br /> W. .#r rover M a-ro-w mol <br /> -5- <br />