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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUMORtzATION.11GNAMAES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUMORIZFt)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 /> I,further, certify under penalty of perjury that I am(check one): <br /> Legat property owner(owner Includes partner, trustee, trustor, or corporate officer)of the property(s)Involved ht this <br /> application, or <br /> O Legal agent(atfach proof of the owner's consent to the application of(lie property's Involved In this application and <br /> have been authorized to rifle on their behalf.,and that the foregoing application staternents are true and correct. <br /> f ,2� '. G <br /> �a L CS1�r Signature. Date: 7- <br /> Print Name: r /LGc,e ✓� G �:. <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> -s- <br />