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L <br /> APPLICATION - MINOISUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: MS - <br /> ` `ALl' kIZATION SIGNATURES <br /> f <br /> ONLY THE OWNER,OF THE PROPERTY OR,AN AUTHORIZED.AGENT MAY FJLE'AN.APPLICATION _. <br /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> employees from any claim, action or proceeding against the Owner/Agent's project. <br /> I, further, certify under penalty of perjury that I am (check one): <br /> 2) Legal property owner (owner includes partner, trustee, grantor, or corporate officer) of the property(s) involved in k <br /> this application, or <br /> a <br /> ❑ Legal agent (attach proof of the owner's consent to the application of the properties involved in this application <br /> and have been authorized to file on their beha7athe foregoing application statements are true and <br /> correct. <br /> Print Name: Patricia Knowles Sign r Date: 09/19/2005 <br /> Print Name: ignature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> k <br /> f <br /> l <br /> N <br /> J <br /> r <br /> { <br /> I'age 7of9 <br /> F:�PEVSV51PIanning Application Form55Minor Subdivision(Rev,6-Q3-04) <br />