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APPLI CA TION�SI TL 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 /> 1,the Owner/Agent agree,to defend,indemnify,and hold harmless the County and its agents,officers and employees from any claim,action <br /> or proceeding against the Owner/Agent's project <br /> 1,further, certify under penalty of perjury that/am(check one): <br /> 0 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 been authorized to file on their behalf.,and that the foregoing application statements are true and correct <br /> Print Name: 7�-qA--No TfL Signature: �^� Date: b3 a7-bp <br /> Print Name: �c�Sh �-- U'!t+J� P`tea Signature. {�G v' Date: sal <br /> Print Name: G5�'�.�N' P a-"-D o Signature: �, �/ A ��z�d _ _ Date: <br /> Print Name: OC-+z�� ?► tea Signature: Date: <br /> Print Name: Signature: Date: <br /> -s- <br />