Laserfiche WebLink
APPLICATION-MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the Owner/Agent agree, to defend,indemnify,and hold harmless the County and its agents,officers and employees from any claim,action or <br /> proceeding against the Owner/Agent's project. <br /> I further certify,under penalty of perjury,that I am(check one): <br /> O Legal property owner(owner includes partner, trustee,grantor, or corporate officer)of the property(s)involved in this <br /> application, or <br /> O Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and <br /> have been authorizcd to file on their beha;,.,and that the foregoing application statements are true and correct. <br /> r <br /> Print Name: Si ���} Signature: Date: <br /> Print Name: _I !j" Y nC�_ Signature: Date: (i�L_.nfC <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> MINORSUBAPP FORM REV. 8-10-01 (IHD) <br /> 5- <br />