Laserfiche WebLink
r <br /> APPLICATION - MAJOk!SUBDIVISION <br />� �QQ�•roG ., <br /> 2•' <br /> �: ya <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> •.. FILE NO: MS- <br /> Rii�iiR <br /> ATI� 'S1uw ? 5 _ M WN <br /> a. �r��.xx ;�d�r���o��r�r = ����� � a>�.A�a�ur�°o�r �����r�,:���►�ra���,�N,��������a�tQ. <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 /> 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 /> 1. <br /> Print Name: Clarke Falrbro#her Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature: Date: <br /> I <br /> i <br /> I <br /> i <br /> ii <br /> I <br /> FADEVSVSIPlanning Application FormsIMAJOR SUBDIVISION(Rev.12-09-04) Page 7 of 9 <br />