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Y <br /> c <br /> APPLICATION - MINOR SUBDIVISION <br /> y0. .Cpl <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> �. .. ;. FILE NO: MS------------------- <br /> AUTHORIZATION SIGNATURES <br /> rren <br /> Y THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN. APPLICATION. <br /> gent agree,to defend,indemnify, and hold harmless the County and its agents,officers and employees from any claim, <br /> eding against the County arising from the Owner/Agent's project. <br /> y,under penalty of perjury,that I am(check one): <br /> l property owner(owner includes partner,trustee,grantor,or corporate officer)of the property(s)involved in this <br /> cation,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 /> LL& Name �o!►r�� r c i Signature: DateV$F-- a-3 d 9 <br /> Signature: 7)' Date: <br /> Signature: Date: <br /> Signature: Date: <br /> Signature: Date: <br /> c <br /> ROEVSVSIPianning Application FormsWinor Subdivision(Rev.05-11-09) Page 7 of 9 <br /> I� <br />