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APPLICATION - MINOR SUBDIVISION <br /> i-: SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> `'' �y � ^ FILE NO: MS- <br /> cerci•'/ <br /> � J <br /> AUTHORMATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY RLE AN APPLICATION. <br /> i,the Ower/Agent agree,to defend,indemnify,and hold harmless the Counly and its agents.ofters and employees from any claim III <br /> action or pro edi rig against he Owner/Agent's pniject ` <br /> I further certify, under penalty of perjury,that I am(check one), ki <br /> Legal property owner(owner includes partner, trustee,grantor: or corporate Officer')of the property-s)im olveo in this <br /> application,or <br /> ❑ Legal agent (attach proof of the owners consent to the applicator:tithe properly's involved in this application and have been <br /> authorized to file on heir behalf.,and that the foregoing application statements are true and correct. <br /> Daniel and Jutilh Van Elderen,Trustees of the Daniel and Judith V Tnr ted 13f64, 75%Interest <br /> Pont Name: Daniel Van Elderen,Trustee Signatire: Date // <br /> Print Name: Judith Van Elderen,Trustee SignData: <br /> Doi Land Grace A.Van Elderen,Trustees of the Van Elderen able Toot under tnstrumene Dated Novr+rrrber 18,1996, <br /> 25%Interest <br /> / l <br /> Vi, <br /> Print Name: Ravid L Van Elderen.Trustoe Signature: �*.�� � ..�-7�-+,t, C 1/ Date: <br /> Print Nome: Grace A.Van Elderen SigrDate: <br /> Print Name: Signat,.re_ Date: <br /> F:IDEVSVS`Fianrinp Applewt3n FpnnFMw5ubplrb'ar(Ra,_1za n Page 5of5 2017461%20MSF'J.it= <br />