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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 penalty of perjury,that I am(check one): <br /> 0 Legal property owner(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 author/zed to file on their behalf.,and that regoing ap lication statements are true and correct. <br /> Print Name: �(Y��iv� � �A%)"6GZ-TSS S�2-Signature: `...�-:thloA `—Date: J <br /> Print Name: 'V-�?Ck (k r n Hill f i-Oh Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: 81011ature: Dater <br /> Print Name: Signature: � Data: <br /> MIMU11NI)I0U'1' 1'01(M MCV, "-10 fit uuul <br />