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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUlN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> AUTHORIZATION SIGNATURES <br /> k ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> i 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees from any claim, <br /> l action or proceeding against the Owner/Agent's project. <br /> I 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 application statements are true and correct. <br /> rme: <br /> j �/ Si atur' Date ���csSige: !Date: <br /> Signature; Date; <br /> Signature: Date: <br /> I. <br /> Signature: Date` <br /> i <br /> S%DEVSVS1Planning Application Formslminor Subdivision(Rex, 12-C9-04) Page 7 of 9 <br />