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C. ) <br /> APPLICATION - MINORSUBDIVISION <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 OwnerfAgent agree,to defend, indemnify,and hold harmless the County and its agents,officers and employees from any claim, <br /> action or proceeding against the OwnedAgent's project <br /> I further certify, under penalty of perjury,that I am (check one): <br /> FY 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 owners 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: MARY SLIKKER Signature: Date: #011-e7 <br /> Print Name: Signature: Deb: <br /> Print Name: Signature: Daps_ <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Daps: <br /> F0EVSVSWIanning Appkatlon Fo sMnw SubdMsian(Re 6.03.04) Page 7of9 <br />