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R <br /> ., 49 <br /> y� ,! C) <br /> sg. <br /> APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ,Af�TI-It3R����"I�ft��I�.�I�►�'�.��� ` <br /> 41t~II Y i HII~, twll "Qll{THS PRPEfT)X.FfM <br /> CkTt <br /> AJTHfIIi11=MfY 4;:.4611 'xi, <br /> I,the owner/Agent agree,to defend, indemnity,and hold harmless the County and its agents,officers and employees <br /> from any claim, action or proceeding against the Owner/Agent's project. <br /> I,further,certify under penalty of perjury that I am (check one): <br /> Legal property owner(owner includes partner,trustee,trustor, or corporate officer)of the property(s) <br /> involved in this application,or <br /> E2 Legal agent(attach proof of the owner's consent to the application)of the owner of the property(s) <br /> involved in this application and have been authorized to file on their behalf,and that the foregoing <br /> application statements are true and correct to the best of my knowledge and belief. <br /> Print Name: Highway 12 Investors, LLC Signature: Date:_ 2 d <br /> Print Name: VC--o1 r') H Signature: � � Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> 3 <br /> i <br /> i <br /> i <br />