Laserfiche WebLink
i a <br /> APPLICATION = MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> :AUTHORIZA77ONSIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AU]fi <br /> ORlZED AGENT MAYFlCE AN APPLlCATlON.' � <br /> 1,the Owner/Agent agree,to defend,Indemnify,and hold harmless the County and Its agents, officers and employees from any claim,action or <br /> M proceeding against the Owner/Agent's project. <br /> i <br /> 1,further, certify under penalty of perjury that t am(check one): <br /> i 1v` Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s)Involved In this <br /> application,or <br /> O Legal agent(attach proof of the owner's consent to the application of the property's Involved In this application and <br /> have been authorized to We on their behalf.,and thatUm foregoing application statements are true and correct. <br /> 7-7 <br /> Print Name: Signature: <br /> to: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name:. Signature: Date: <br /> M <br /> :_-.�. -'r"�-„=� .--.�= cls:-e a ----'�.---�_r;c-:r'.� ..__� _ _--^�--"----•_---�- ---.rte--� - .- _, —_ <br /> -5- <br /> l _ - <br />