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4� '. APPLICATION - MINOR SUBDIVISION <br /> r <br /> c 1 � <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGED 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 arty daim, <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 indudes partner,trustee,grantor,or corporate officer)of the Property(s)involved in this <br /> application,or <br /> ❑ Legal agent(attach proof of the owners 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 statame re true and coned. <br /> Prim Name: Signature: <br /> Date: �( -2�.� <br /> Print Name: Signature: Date. <br /> Prim Name: Signature: DBDe: <br /> Prim Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F V)Evsyswkvv,1no AOp+radon FmviskMw Swdki o crrev.643a1 Page 7 of 9 <br />