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APPLICATION - MAJOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> AIJTHOR1Z;,q ON SIGNATURES, I: ' <br /> t <br /> ONI:Y THEOWNER`OF THE PROPERTY OR AN�AUTHQRIZFO AGENT MAY FILE.AN ;'APPLICATION. <br /> #, 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 /> I 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 /> APN 255-170-01: <br /> Carl Bart Navarra and Annamae Frances Navarra, as Trustees of the Carl and Annamae Navarra Trust as Amended and <br /> restated 2010, 12%,interest <br /> Print Name: Carl B. Navarra Trustee Signature: C l��'f C� Date: <br /> Print Name: Annamae F. Navarra,Trustee Signatureli Date: <br /> Carl M. Navarra,as Trustee of the Navarra Living Trust, Dated Dece a 95 2009 /. nterest <br /> Print Name: Carl M_Navarra,Trustee _ Signature: Date: <br /> APN 255-170-10: CPC Navarra <br /> Print Name: Carl B. Navarra Signature: Date: <br /> I <br /> ',,DEVSVW1annirig Application Forms\Major Subdivision(Rev,M-11-09-04) Page 5 of 5 2011-168 Major Subdivision.doc <br />