Laserfiche WebLink
i <br /> APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNfTY DEVELOPMENT DEPARTMENT <br /> AUTH0RtZATXW3l iNATURES. <br /> ONLY THE:OWNER OF THE PROPERTY 0R-AfJ:AlJ*TH0gtZWAGENTMAY 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,action <br /> or proceeding against the Owner/Agent's project <br /> I, further, certify under penalty of perjury that I am(check one): <br /> I <br /> ❑ Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s) involved in <br /> this application,or <br /> ❑ Legal agent(attach proof of the owner's consent to the application of the property's Involved In this application <br /> and have been authorized to isle on their behalf,and that the foregoing application statements are true and <br /> correct. <br /> i <br /> Print Name: �- �Q Y!')IJUv/ Signature: Date: <br /> / , y r <br /> Print Name: t-7 7- ��f//'--V'`7C) Signature: � T''Date: �/ma/ 1 Y 7 <br /> Print Name: (J Signature: L,.�, `rr Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />