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OUIN <br /> APPLICATION - MINOR SUBDIVISION <br /> F < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> Oq�%F OR�`P <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE 77APANvTION. <br /> I,the Owner/Agent agree,to defend, indemnify, and hold harmless the County and its agents,officers anm any claim, <br /> 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 propin this <br /> application,or <br /> ❑ Legal agent(attach proof of the owner's consent to the application of the property's involved in and have been <br /> authorized to file on their behalf.,and that the foregoing application statements are true and co <br /> Stanley Enterprises \ <br /> Print Name: A n )1 Y yY S t� LC l Signature: <br /> � Date: d 5 2, <br /> i <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:IDEVSVS\Planning Application Fonns\Minor Subdivision(Rev.12-09-04) Page 5of5 2015-140 Minor Subdivision <br />