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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUtH(*12ATlOIV'S IGNATURES <br /> i <br /> QNLY.THt?OWNER dF THE PROPERTY OW: N.AUTHORIZE©'AGENT'I.tAY FIL1=AN,APPCICATiQN <br /> I,the Owner/Agent agree,to defend,Indemnity,and hold harmless the County and its agents,officers and employees from an <br /> or proceeding against the Owner/Agent's project, Y claim action <br /> 1,further, certify under penalty of perjury that I am(check one): <br /> I Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s)Involved in <br /> this application,or <br /> Legal agent(attach proof of the owner's consent to the application of the property's Involved In this application <br /> and have been authorized to file on their behalf.,and that the foregoing application statements are true and <br /> correct. <br /> Print Name: ?A) <br /> Signature: Date: <br /> Print Name: <br /> Signature: Date: <br /> Print Name: <br /> Signature: Date: <br /> Print Name: <br /> Signature: Date: <br /> Print Name; <br /> Signature: <br /> Date: <br /> I� <br />