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AWLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: 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 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 /> F1 Legal property owner(owner includes partner, trustee, grantor, or corporate officer) of the property(s) involved in <br /> this application, or <br /> ❑ 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 /> Print Name: Robert H. Frost Signature: _ Date: 9 Io^dq.0— <br /> AoffPrint Name: Mary Jane Frost Signature: �j4« �y�/ Date: g <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F\DE SVMPIammng Appl,mlion Fon sNMinor Subdivision(Rev.6.03-04) Page 7 of 9 <br />