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J <br /> APPLICATION <br /> MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ,... ?_,.AUTHORfZATIO SIGNATURES,..; ' <br /> r <br /> ONLY:1}iE OWiifER OF ROPERTY OR'AN.-AUTHOR D AGEIhLT'NIAIF FIL AISE.APPLICATIt)N. -. <j. <br /> 1,the OwnerfAgent agree,to defend,Indemnify,and hold harmless the County and its agents,officers and employees from any claim,action <br /> or proceeding against the Owner/Agent's project. <br /> I,further, certify under penalty of perjury that 1 am(check one): <br /> Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s)Involved in <br /> this application,or <br /> © 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 file on their behalf.,and that the foregoing application statements are true and <br /> correct, <br /> Print Name: Zlr6 JJ�L�. !Q/�l�P Signature: <br /> L92a aate:O <br /> Print Name: a Signature: '�.Q�imn,�pyJ �,�- -- Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> I <br /> I <br /> a <br /> i <br /> a <br /> 1 <br /> —4— <br />