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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORtZAllidi '§IGNA-TURES <br /> ONLY THE OWNER OF THE:PROPERTY ORAAkAtJ MR= AGENTMAY FILE AN APPUCATION.. <br /> I,the Owner/Agent agree,to defend,Indemnity,and hold harmless the County and Its agents,oMcers and employees from any claim,action <br /> 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)of the property(s)involved in <br /> this application,or <br /> ❑ 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;—Delbr—A (YEJA Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />