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APPLICATION MAJOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS <br /> N11 'N <br /> wffllmff <br /> Is L <br /> P"T <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 Owner/Agent's project. <br /> I further certify, under penalty of perjury,that I am (check one): <br /> x 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 owners 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: FrederickGudelF711Q_JafjCJ( J;1LJ0_J Signature. Date:/a--27-D4 <br /> ati, <br /> Print Name: Alice Gudel 7 c c. 6, L Signature. Date: /.1 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> -Print Name: Signature: Date: <br /> rr <br /> F:\DEVSVS\Planning Application FormsWAJOR SUBDIVISION(Rev.6-03-04) Page 7 of 9 <br />