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APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: MS- <br /> AUTHORIZATION SIGNATURES <br /> ONLY T0E,OWNER;O,F.;THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION <br /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> employees from any claim, action or proceeding against the Owner/Agent's project. <br /> I, further, certify under penalty of perjury that I am (check one): <br /> p Legal property owner(owner includes partner, trustee, grantor, or corporate officer)of the property(s)involved in <br /> this application, or <br /> E] Legal agent(attach proof of the owner's consent to the application of the properties involved in this application <br /> and have been authorized to file on their behalf and that the foregoing application statements are true and <br /> correct. <br /> J <br /> Print Name: Harry T. Terpstra Signature: �i <br /> ✓ Date: <br /> Print Name: Rhea A. Terpstra Signature: Date: C <br /> Print Name: Mike Terpstra Signature: Date: l f-C9T <br /> Print Name: Holly Terpstra Signature: Date: <br /> Print Name: Steve Terpstra Signature: Date: l a� <br /> Print Name: Nancy Terpstra Signature: Date: <br /> F OUSVSW nning Applimtion Fa X!Wina Subdmslon(Rev.6-OS-04) Page 7 of 9 <br />