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� y <br /> aa� APPLICATION - MINOR SUBDIVISION <br /> Ic <br /> .� SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <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 defend,Indemnify,and hold harmless the County and Its agents,officers and employees from any claim, <br /> action or proceeding against the Owrw/AgenVs project. <br /> I further certify,under penalty of perjury,that I am(check one): <br /> I� Legal property owner(owner Includes partner,trustee,grantor,or corporate officer)of the propeny(s)involved in this <br /> application,or <br /> ❑ 'Legal agent(attach proof of the owneds 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 correct. <br /> Print Name: G S44 Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FADEVSVSV4am q Appdcadon FormsW w sLtmAsion(Rett.72-ogo4) Page 7 of 9 <br />