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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT . <br /> PILE NO: MS- <br /> AUTHOPAMTION SKMATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORWM AGENT MAY FILE AN APPLICATION. <br /> I,the OwneNAgent agree,b defend,indemnify,and hold harmless the County and its agenft offers and employees from any daim, <br /> scion or proceeding agabst the OwrKdAWKs pmject. <br /> I further certify,under penalty of per jury,that I am(check one): <br /> ❑ Legal property owner(owner incudes partner,muscae,grantor.or corporate otfroer)of the property(s)involved in this <br /> application,or <br /> ❑ Leo agent(altsrh proof of the owners consent to the application of the property's involved In this application and nacre been <br /> suMortod toAis on tl�*behalf..end that the foregoft appficadon shMemerft we true and caned <br /> peat Phillip Chinchiolo & Son ve per; <br /> Print Name: Signature: Daae: � <br /> Print Nance: Signature: Dale: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Dais: <br /> * By Robert Chinchiolo, Officer <br /> i <br /> i <br /> i <br /> h <br /> i <br /> F:OEvSVSVnanNng Appk*don Fame MAhor Sub mss(Rev.s-O-a+) Page 7 of 9 <br />