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APPLICATION - MINOR SUBDIVISION <br /> L A <br /> m < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I,the Owner/Agent agree,to defend,indemnify, and hold harmless the County and its agents, officers and employees from any claim, <br /> action 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,grantor,or corporate officer)of the property(s)involved in this <br /> application, or <br /> ❑ Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and have been <br /> authorized to file on their behalf., and that the foregoing application statements are true and correct. <br /> APN 252-100-01: Kenneth G. Robertson and Deborah W.Robertson,T s e of t e Robe o 20 Trust Dated April 20,2011; <br /> Kelly Robertson —� <br /> Print Name: Kenneth G.Robertson,Trustee Signature: i Date:J �///.3 <br /> Print Name: Deborah W. Robertson,Trustee Signature: ate:4? <br /> Print Name: Kelly Robertson Signature: Date: <br /> APN 252-100-02: Kenneth G. Robertson and Kelly Robertson as Succ Co- rust s of the Cerald Robertson Living Trust, <br /> Dated August 9, 2002 y� <br /> Print Name: Kenneth G. Robertson,Successor Signature w.'G Dater <br /> Co-Trustee <br /> Print Name: Kelly Robertson Successor Signature: Date: i 23 3 <br /> Co-Trustee <br /> F:\DEVSVS\Planning Application Fomnswinw Subdivision(Rev.12-09-04) Page 5 of 5 2013-02 Minor Subdivislon.doc <br />