Laserfiche WebLink
4u�f+ <br /> APPLICATION - MINOR SUBDIVISION <br /> i0 SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> •��FQP� <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 hold harmless the County and its agents,officers and employees from any claim, <br /> action of proceeding against the Owner/Agent's project. <br /> I 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 rile on their behalf., and that the foregoing application statements are true and correct. <br /> Print Name: _J TA m�S v RyAJaignature: Date: <br /> Print Name: Say-,E�12 P, BA�ignature: <br /> Print Name: � C' ry-.,, gnatrn <br /> /,�i�latfire: <br /> Print Nam C �- 0//`/tiSi <br /> y/log Date: <br /> Print Name: Signature: Date: <br /> F:%DEVSVS�Planning Application FormsMwr Subdivision(Rev.12-0400 Page 7 of 9 <br />