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`APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> Sir F ORS <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 /> KEITH ROBERTSON AND JANICE ROBERTSON,AS TRUSTEES <br /> UNDER DECALRATION OF TRUST DATED MARCH 20, 1996 <br /> Print Name: KEITH ROBERTSON,TRUSTEE Signature: ate:////Al —,R <br /> Print Name: JANICE ROBERTSON,TRUSTEE Signatur Date:`41,f—/6 <br /> HAL S. ROBERTSON & COURTNEY V. ROBERTSON,TRU EES OF <br /> THE ROBERTSON FAMILY LIVING TRUST, DATED FEBRUARY 23, 1995. <br /> Print Name: HAL S. ROBERTSON,TRUSTEE Signature: u/�AT,,4ttl D'ate: y1'a k-1 o <br /> Print Name: COURTNEY V. ROBERTSON,TRUSTEE Signature: ✓ ate: <br /> R\DEVSVS\Planning Application Formswinor Subdivision(Rev.12-09-04) Page 5 of 5 2010-60 MS.doc <br />