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Doc 10 15 04:46p Aspen Survey Company 12095260472 p.6 <br /> 46 <br /> APPLICATION - MINOR SUBDIVISION <br /> 1 SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> / FILE NO! MS- <br /> � / <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1,the Owner/Agent agree,to daiand,Inoamnify,anti hold harmless the County and It-agents,oRlcem and employees frorn any claim, <br /> action or proceeding against the County arising from the OwnerlAgent's project <br /> I further certify,undar penalty of pedury,that 1 am(check one): <br /> 13 legal property owner(owner includee partner,tnrstaa,grantor,or corporate officer)of the property(s)involved in this <br /> application,or <br /> [] Legal agent(attach proof of the owner's oonsent bathe application of the properb/s involved in this application and have been <br /> a thorned to file on their behalf.,and That the foregoxq applkEtlon statements are we and correct. <br /> FP�intNarne: C'�94 W 7 q; lig-1^IAe�. Signature: l Data.ame: �(' E�%t �.,A w' Kr_ Signature: <br /> Print N arae: Slgnaturo: Deft: <br /> Print Name: Signature: Date: <br /> Print Names Signature. Date: <br /> Fib EVSVSPbmina ADalir bn Fm.dNkmr SLedei ba IRev,p577-09; Page of <br />