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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONL Y THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I, the OwnerfAgent 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 1 am(check one): <br /> O 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 rile on their behalf,and that the foregoing application statements are true and correct. <br /> Print Name: �7 . iL �;G Signature: /7t» �i �- � >S `✓ Dater S 2— <br /> Print <br /> Print Name: Signature: Date: <br /> PNnt Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />