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APPLICATION - MAJOR 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 AG,ENT NT-MAY°FILE AN APPLICATION. <br /> faction <br /> Owner/Agent agree,to defend,indemnify,and hold harmless the County and its agents,officers and employees from any claim, <br /> or proceeding against the County arising from the Owner/Agent's project. <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 ap lication statements are true and correct. <br /> Print Name: -✓DsePH A, MART(lt1eZ Signatur . �• Date: 2/211 <br /> Print Name: �Iy�f1 Irf/! M`Ai>�n I✓�� <br /> Signat Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name., Signature: Date: <br /> j F:1DEV9VSIPIann1ng Appl"lion FormMMAJOR SURD WISPON(Rev,05-11-0"4) Pane 7 of g <br />