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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, 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 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 /> Tony Silva&Sons Dairy,Inc. <br /> Print Name: ��/ �i� Signat ate:lo/1 <br /> Print Name: Signat re: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:\DEVSVS\Planning Application Forms\Minor Subdivision(Rev.12-0944) Page 5 of 5 <br /> 2016-75 Minor Subdivision <br />