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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> i. <br /> FILE NO: MS- <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 I am (check one): <br /> US Legal property owner(owner includes partner,trustee,grantor,or corporate officer)of the property(s)involved in this <br /> application,or <br /> e application of the property's involved in this application and have been <br /> El Legal agent(attach proof of the owner's consent to th <br /> authorized to file on their behalf., and that the foregoing application statements are tr and torr <br /> Date: )c <br /> Print Name: X rZ � �dl7ar� Signature: X 111 <br /> Print Name: Signature <br /> Date: <br /> Signature: <br /> Date: <br /> Print Name: Date: <br /> Signature: <br /> Print Name: Date: <br /> Print Name: <br /> Signature: <br /> Pa e7of9 <br /> f?DEVSVS\Planning Application Forms\Minor Suhtlivision(Rev.05-11-09) 9 <br />