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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY'.THEOWNER OF:THE.PROPEATY012AN:AUT00RIZEDAGEWMAYFILEAN APPLICATION.- <br /> I,the Owner/Agent agree,to defend,Indemnify,and hold harmless the County and He agents,officers and employees from any claim,action <br /> or proceeding against the Owner/Agent's project. <br /> I,Wither, certify under penalty of perjury that I am(check one): <br /> Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the propenyls)Involved In <br /> this application,or <br /> O 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 Elle on their behalf.,and that the foregoing application statements are true and <br /> correct. <br /> Print Name:\TL,�'F� Signature:C � 1\2 Date: !L/3, ( ('_ 3 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> J��1 <br /> -5- <br />