Laserfiche WebLink
4u N\ APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> ��rFORa <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT 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 any claim, <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 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 ohe property's involved in this application and have been <br /> authorized to file on their behalf., and that the foregoing application s ements area true and correct. <br /> Print Name: !$AZ.Y4 F{AO . M/Aollt Signature: / �iG(• �S/V D!o Date: <br /> Print Name: A+)rAA47- S. "14w, Signature: � 1"iff S• Irffill.0 Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:\DEVSVS\Planning Application Forms\Minor Subdivision(Rev. 12-09-04) Page 7 of 9 <br />