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APPLICATION - MAJOR SUBDIVISION <br /> N: <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> rw ° 'Nib ', <br /> { <br /> aa� <br /> I,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 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 /> Print Name: J-9 A )rS� Signature: Date: <br /> Print Name: Signature: Date: ((( <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> �eveye� li��loS <br /> F:\DEVSVS\Planning Application Forms\MAJOR SUBDIVISION(Rev.12-09-04) Page 7 of 9 <br />