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APPLICATION - MINOR SUBDIVISION <br /> `�'�s ,• j SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> i ; <br /> FILE NO: MS- <br /> �' 7 <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY 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, <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, - Signature: �� E" C'�2LS`�~ Date: ?j1?-10 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />