Laserfiche WebLink
MAIN <br /> c° APPLICATION — MINOR SUBDIVISION <br /> IOrI�,,�g SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> IISe FILE NO: M5- NA � <br /> I Li�oRit <br /> I <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I,the Owner/Agept agree,to defend,indemnify,and hold harmless the County and its agents,officers and employees from any claim, <br /> action or proceeding against the Owner/Agent's project. <br /> further certify,under penalty of perjury,that I am(check one): <br /> Legal property owner(owner includes partner,trustee,grantor,or corporate officer)of the property(s)involved in this <br /> application,or <br /> ❑ Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and have been <br /> authorized to file on their behalf.,and that the foregoing application statements are true and correc <br /> Print Name: l,P� !y r k� Signature: 21gg� Date: 7'14"zlxb$ <br /> Print Name: Signature: Date: <br /> Print Name: Signature: D <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> 1 <br /> FADEVSVSPIanning AppficMlon FnansUnor Subdivisson(Rev.12-09-04) Page 7 of 9 <br />