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APPLICA I ION - MINOR SUBDIVISION! <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT' <br /> .. . <br /> AUTHORIZATION SIGNATURES'.: <br /> ONLY THEOWNEROFTHE.PRO PERTYORANAUTHORIZED'AGENT.MAY.FILE AN APPLICAT10N..- <br /> I,the OwnerlAgent 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 /> 1, <br /> rojectI, further, certify under penalty of perjury that I am(check one): <br /> Cl Legal property owner(owner includes partner,trustee,trustor,or corporate officer)of the property(s) involved in <br /> this application,or <br /> Cl 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: Signature: ;� L` (• 1 ' y i t Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />