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l <br /> 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 AN APPLICATION. <br /> I,the Owner/Agent agree,to defend,IndemnPy,and hold harmless the County and Its agents,officers and employees from any claim, <br /> action or proceeding agalnst the Owner/Agents 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 /> 0 Legal agent(attach proof of the ownees consent to the application of the property s Involved in this application and have been <br /> authorized <br /> ddxto Me on their homif.,and that the foregoing application statements are nue and <br /> Print Name: `�/ V C� \G�%� Signature: <br /> Print Nama: signature: <br /> Print Name: Signature: <br /> Prim Name: Signature: <br /> Print Name: Signature: <br /> FADEVSVS~d*V/pAIraam Furms"w Ub&Ww(RL .12.00 I) Page 7 of 9 <br />