Laserfiche WebLink
P FILE NO: MS- <br /> u'" APPLICATION - MINOR SUBDIVISION <br /> w < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> �,Ci�o-iM1Hvp <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 statemen arq^e and correct. <br /> Print Name: !oz,noz, Signature: Date: 71/I prs <br /> Print Name. Signature: Date: <br /> Print Name. Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:\DEVSVS\Planning Application FomsWinor Subdivision(Rev.05-77-09) Page 7 of 9 <br />