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V <br /> APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT - <br /> AUT14ORIZATION 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 I am(check one): <br /> 16 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 file on their behalf.,and that(lie foregoing application statements are true and correct. <br /> Print Name: <br /> /l1!/7�E/� LL Signature Date: <br /> Print Name: . e ISignature: Date: 1:3 � <br /> Print Name: t Signature: — Date: <br /> Print Name: c �xfJv �Z VI Signature: Date: l6 00 <br /> Print Name: T Signature: Date: <br /> -5- <br />