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° APPLICATION - <br /> `{ MAJOR SUBDIVISION <br /> i : <br /> jSAN 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 /> 0 <br /> Print Name: � ' ��� C . '��I�� <br /> Signature: � 7"���=�"w'Date: �' G`O7 <br /> Print Name: CG(l�(j I y►') �(,�( � <br /> Signature: <br /> Print Name: ate: <br /> Signature: - Date: <br /> Print Name: Ci Signature: VOW <br /> LpDate: <br /> Print Name: .C 7CZ✓�� �14!l, 1 T Signature: 1-?0K <br /> Date: C� f -7 <br /> FOEVSVS%Planning Application Forms\MAJOR SUBDIVISION(Rev.12-09-04) Page 7 of 9 <br />