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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> Y. <br /> FILE NO: MS- <br /> </PORN <br /> AUTHORIZATION SIGNATURES <br /> 7rapplicabon, <br /> THE 0, tlk OF THE PIRQPERTY OR AN AUTHORISED AGENT MAY FILE AN APRL[CATION. <br /> ent agree, to defend, indemnify, and hold harmless the County and its agents,officers and employees from any claim, <br /> ding against the County arising from the Owner/Agent's project. <br /> under penalty of perjury,that I am (check one): <br /> property owner(owner includes partner,trustee, grantor, or corporate officer)of the property(s)involved in this <br /> tion, 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: ��j/A+/ u1E�i �` Signature:l ��— <br /> Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F OEVSVMPIanninn AnMiratinn 0---1 s n <br />