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s <br /> APPLICATION - USE PERMIT <br /> F - SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT ' <br /> ' <br /> AUTHORIZATION.SIGNATURES <br /> .. <br /> ONLY THE QWNER OF THE PROPERT.Y:"CR:AN:AUTFIORIZEO'AGENT MAY.FILEAN APPLICATION. <br /> f, the Owner/Agent agree, to defend, indemnify, and hold'harmless the County and its agents, officers and <br /> employees 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) <br /> of the property(s) involved in this application, or: :�• F ` .t.� <br /> ` <br /> 0—""' Legal agent (attach proof of the`owner's consent to the application of the property's <br /> involved in this application and have been authorized to file on their behalf., and that <br /> the foregoing application statements are true and correct. <br /> r <br /> Print Name: Signature: _ Date: <br /> Print Name: - - _._ _. w.. t . _ Si <br /> Egnature: -Date: - <br /> - I <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: ' <br /> Print Name: Signature: Date: <br /> L' <br /> �i <br /> . ,R :z-- _ - r ., .. ..wr+.....r- ... ....w.,.max.• _ .r.. ..... - _.. ..- - ... .. t. _.. ,w. .. __ � I <br />