Laserfiche WebLink
APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> AUTHORLtATION SIGNATURES <br /> FONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AG'E'NT 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 /> r <br /> Print Name: Signature: YaX Date: ! <br /> XVI7 <br /> Print Name: A` Signature: / Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> E <br /> f <br /> i <br /> F:IaEVSVS\Planning Application FormnNminor Subdivision(Rev.12-09-04) Page 7 of 9 <br /> { <br />