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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 /> I further certify,under natty of perjury,that/am(check one): <br /> Legal property that <br /> (owner Includes partner,trustee,grantor,or corporate officer)of the property(s)Involved in this <br /> application,or <br /> 0 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:�o I _ Ll `Xk'm Signatu Ite: An _0 Z. <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> W NORSUBAPP rom AEV. 0-10-01 11HW <br /> -5- <br />