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APPLICATION, - MAJOR SUBDIVISION <br /> ' SAN JOAQUiN COUNTY COMMUNITY DEI/ELOPMENT DEPARTMENT <br /> F LNO Ms <br /> -77 <br /> r �F <br /> I sthe OwnedAg'ent agree;to defends rndemnP. lfy,and fiol�i Harmless the County rand Its agents,officers and employees from any claim <br /> ;action`orproeeedingagalnstthe t�wnetlAgent's protect <br /> further certify;under'penalty of perfury that;l am(check one) <br /> r <br /> Legal property owner.(owner.Incllude"s partner trustee,grantor or corporate officer}of the.property(s)Involved Inthls <br /> applicatlon,9r :- <br /> Legal`a6 nt(attach:proof 0 the owner's consent to;fhe application of the,pro e' "s Invoiued.In.this a iication and have.been <br /> p .rty pp <br /> authorised to'file on their tietaif arts that tFie fore`oln 'a 'Ilct"ion statements ar t <br /> 9 g ..pp. a rue and,correct.' <br /> Print Name: S nature: Date:7�L��� <br /> Print Name: Signature: Dato: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> i <br /> I <br /> i <br /> E <br /> i FIDEVSMPIanning Application Forms\MAJOR SUBDIVISION(Rev.12-09-04) Page 7 of 9 <br /> d <br />