Laserfiche WebLink
APPLICATION - MINOR SUBDIVISION <br /> z, <br /> ' tl SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> AUTHORIZATION SIGNATURES <br /> ONLY7OWNEREPROPERTY ORANAUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I,the Owner/Agedemnify,and hold harmless the County and its agents,officers and employees from any claim, action or <br /> proceeding againproject. <br /> 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: r, (t7 C4 c_ c/ Signature: �� Date: /S-17-07 <br /> Print Name: _ M Q ,y t� .�. Cb- o, Signature: cs...�. G.-, �—o tl a, Date: /13. 1171,7 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:\\DEV5V5\\Plann1ng Application Forms\\Minor Subdivision(Rev.12-09-04) Page 7 of 9 <br />