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U��!" APPLICATION - MINOR SUBDIVISION <br /> ;o 'coo <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> AUTHORIZATION SIGNATURES <br /> r <br /> E OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> er/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> from any claim, action or proceeding against the County arising from the Owner/Agent's project. <br /> certify under penalty of perjury that I am (check one): <br /> property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> d in this application, or <br /> agent (attach proof of the owner's consent to the application of the property's involved in this n statementsation and have been authorized to file on their behalf., and that the foregoing app <br /> are true and correct. <br /> Date: 11- 10 14 <br /> : t aY Signature: <br /> 1 Date: r{ — 10 <br /> Print Name <br /> Print Name: i't•� tt Signature: <br /> Signature: �_--cy`�~^ Date: <br /> Print Name: <br /> �� -�-�-- <br /> Date: _ <br /> Signature: <br /> Print Name: Date: <br /> Print Name: _ <br /> Signature: <br /> Pa e7of9 <br /> F:IDEVSVS1Planning Application Formswinor Subdivision(Rev.05-11-09) 9 <br />