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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ALlTH0R1ZA710N SIGNATURES':. <br /> ONLY THE.OWNER OF THE.PROP£RTY•DRAW-AJJ7140RIZE AdENTMAY F1LEAN APPLICAT10N. <br /> I,the Owner/Agent 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 /> Legal property owner(owner includes partner,trustee,trustor,or corporate ofticer) of the property(s) invaived in <br /> this application,or <br /> 0 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: /t G'y S r �it[/(6 <br /> r "signature: Date: <br /> Print Name: I l Signature: Date: <br /> I <br /> Print Name: Signature: Date: <br /> I <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />