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41y, PPLICATION - 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, action or <br /> 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 /> Print Name: Greg Rausser Signature: Date: <br /> Print Name: Eleanor Rausser Signature: 44-,...,,./ ot�1� Date: <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 />