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>a" APPLICATION — MAJOR SUBDIVISION <br /> a SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> [rFOFP <br /> AUTHORIZATION SIGNATURES FILE NO: MS- <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 /> rther 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 /> �\ 'tapplication,or <br /> t��vt.age]agent(attach proof of the owner's consent to the application of the property's involved in this application and have been <br /> /"V authorized to file on their behalf.,and that the foregoing application statements are true and correct. ^'l <br /> Print Name: Lfl /� JGh r• Signature. ^'moi Date: o)_� `O / <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FADEVSV&Planning Appli"tion Forms\MAJOR SUBDIVISION(Rev.12-09-04) Page 7 of 9 <br />