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APPLICATION - MINOR 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 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, <br /> action or proceeding against the County arising from the Owner/Agent's project. <br /> 1 further certify,under penalty of perjury,that I am (check one): <br /> Legal property owner(owner includes partner,trustee,grantor, corporate office 1 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 a e ect. <br /> --Print Name. ( Ili%at r Signature: Date: /J/Joh 2- <br /> Print <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature. Date: <br /> F\DEVSVSManning Application FormsiM,n Su50ivisron(Rev.05-11-03) Page 7 of 9 <br />