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r _ <br /> APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the Owner/Agent agree, to defend,indemnify,and hold harmless the County and its agents, officers and employees from any claim,action or <br /> proceeding against the Owner/Agent's project. <br /> 1, 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 this <br /> application, or <br /> O Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and <br /> have been authorized to Me on their behalf., and that the foregoing application statements are true and correct. <br /> Print Name: Signature: • � f,! r�(2-(2— Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> -s- <br />