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{ <br /> APPLICATION - MING SUBDIVISION <br /> ` SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- - <br /> lF ORS <br /> { AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I,the OwnertAgent 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 fife on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: iG Jr/- 14,rz,1?'4 Signature: �i�` ' lr Date: <br /> Print Name: f�'v'L�C ` ! Signature: r G�Z U` Date: <br /> Print Name: ' l1< l 1c L� Signature: �� f Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:1pEVSVS1Planning Application Formswinor subdivision(Rev.12-09-114, Page 7 if 9 <br />