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APPLICATION- MAJORSUBDIVISION <br /> P <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> t�' <br /> g AUTHORIZATION S{GNATURES <br /> O[VLYyTHE OWNER OF THE PRUPEftT1f,OR,AN AEJTHOWE6 GENT MAY FiI_E AN'AlOOLWATION.� <br /> ,:.•er9.�.a�.. '--'.-..cm¢ietir-�wwn. +ti�AMsuu".ml-1rw.�bl'i+e4•v?t i.i:b�'cdr, re-sw% :�..asmrMY:+ir.� <br /> I;the Owner/Agent agree,to defend,indemnify,and hold harmless the County and its agents,off icers.and employees from any claim, action or <br /> 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 sttements are true and correct. <br /> Print Name: Steven E.Pechin Signature: Date: 11/01/2405 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FMDEV5V511PIannrng Application FormsMAJOR SUBDIVISION(Rev.12-09-04) Page 7 of 9 <br />