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APPLICATION - MINOR SUBDIVISION <br /> z. .y <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> ... <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I,the Owner/Agent agree,to defend, indemnify, and hold harmless the County and its agents, officers and employees from any claim, <br /> action or proceeding against the County arising from the Owner/Agent's project. <br /> I further certify, under penalty of perjury,that 1 am (check one): <br /> y� 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 /> �n`1 Signature: i Date: <br /> Print Name: <br /> Print Name:L� <br /> �/////4 /1T�n/FZ- Signatur �" Date:/Z <br /> Print Name'. <br /> Signature: Date: <br /> Print Name. <br /> Signature: Date: <br /> Print Name: <br /> Signature: Date: <br /> Pa e7of9 <br /> F'\DEVSVSWIaaning pppication ForrnsWirtor Subdivision(Ray.05-11-o9) 9 <br />