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APPLICATION - MINOl SUBDIVISION <br /> .o� <br /> Q` - •' ' 'Z� SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> _ :p <br /> �4<i E oti�'v <br /> AUTHORIZATION SIGNATURES <br /> rlAen <br /> THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> ent agree,to defend,indemnity, and hold harmless the County and its agents,officers and employees from any claim, <br /> eding against the Owner/Agent's project. <br /> ,under penalty of perjury,that I am (check one): involved in this <br /> l property owner(owner includes partner,trustee,grantor,orcorporate officer)of the property(s)'cation,orved in <br /> Legal agent ri ed to ftte onPheir behalf.,and that the forego fonsent to the regoing ion of the pr( <br /> statements are true land correcapplication <br /> ppltcat on and have been <br /> ,�/n [ ate: -.?/•O <br /> Signature: .��tT <br /> Print Name: DirkDvkxhoom �<awie �� — am <br /> Date: 3.at-07 <br /> Print Name: U0 aa1 - N�0•rIE �> IGX�00Ir Signature: Date: Z �/vim <br /> Print Name: Dr fk LQUYCris D s' OO I Signature: <br /> rS /I '/ Date:PrintName: gArrell /'t• V oorto /, Signature: /9, y/ 3/a 3 07 <br /> Ij.',4et6e, . 4. (/ n Date: <br /> Print Name: EUa/LE F 1/vORTir1AM Signature: �" <br /> AUL DOeT/nAA/ <br /> Pa e7of9 <br /> F:\DEVSVS\Planning Application Forms\Minor Subdivision(Rev.12-09-04) g <br />