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APPLICATION Y N MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> ONLY' <br /> SIGNATURES <br /> ONLYTHE OWNER OjF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I,the OwnedAgent 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 /> 1 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 /> I 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 /> Print Name: AQ_ZU%/i/ 14 Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print[dame: Signature: Date. <br /> Print Name: Signature: <br /> Date: <br /> . I <br /> I <br /> k <br /> J <br />