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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 />l� 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 />Print Name: 33-4-,p /7(porH2Signature: Date: Y -la -0 % <br />V <br />Print Name: Z 1571 r J P . � tW_ / "gnature: Date: 4,/9"07 <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 />