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ag4Utn APPLICATION — MAJOR SUBDIVISION <br /> e SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: 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 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 owner's 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: [{r.__�� �1 Signature: Date: 5-- /jr-d S' <br /> Print Name: Signature: Gate: � <br /> I <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FTEVSVS�Planning Application For sWAJOR SUBDIVISION(Rev.6-03-04) Page 7 of 9 <br />