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• qu1N <br /> APPLICATION - MINOR SUBDIVISION <br /> 2: <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> </FORS <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 County arising from 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: N b W rd iNJ Signature: r Date: ]E 1711 <br /> Print Name: A u 1 t,-7 (J Signature: (u ldc n V Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FIDEVSMIRianning Application FoansWinor Subdivision(Rev.05-11-09) Page 7 of 9 <br />