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� u . APPLICATION - MINOR SUBDIVISION <br /> ` 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.A.N. ?:APPLICATION " x?,.;;r „ <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 County arising from the Owner/Agent's project. <br /> 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 /> LZy Legal agent(attach proof of the owner's consent to the application of the roperty's involved in this application and have been <br /> // authorized to file on their behalf., and that the foregoing applic • n state nts are true and correct. <br /> Print Name: --fps e a fi L^ �* Signature: / Date: ?17-4) 5! <br /> Print Name: Gr_c r SQ►-�__,9_ Signature: Qv Date: 7-/7- 09 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: . Date: <br /> Print Name: Signature, Date: <br />} <br />} <br /> S <br /> 1 <br /> 3 <br /> 1 <br />} <br /> i <br /> i <br /> 1 <br /> i <br /> 1 <br /> F:1DEVSVS1PIanning Application Formswinor Subdivision(Rev.05-11-09) Page 7 of 9 <br /> 1 <br />