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APPLICATION - MAJOR'SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> /F. FILE NO: MS ----------- <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 Favid harmless the County and Its agents,officers and employees hon any claim. <br /> action or proceeding ageYpR the Owner/Agents project. <br /> I huUrer certify, under penalty of perjury,That I am(check one): <br /> ❑ Legal property owner(owner includes partner,trustee,grantor,or corporate officer)of the properMs)involved in this <br /> appikadon,or <br /> El Lepel agent(attach proor of the owners consent to the.pplicagott of preparys invdred in this application and neve been <br /> autharred to So on their behalf..and Met the foregoing appirWm slsYntetrs N true and correct. <br /> Print Name: ETc z T Z E,T�.z Slgnature: T Z Date: ZAV/o b <br /> Prim Name: Signature: Date: <br /> Print Name: Signature: Data <br /> Print Name: Signature: Data: <br /> Print Name: Signature: Date: <br /> F VEVSVS1PIwWq AppAcaMm Fo ,%MAIOR SUBDIVISION(Rev.GBSM) Page 7 of 9 <br />