Laserfiche WebLink
APPLICATION - MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELorMENT DEPARTMENT <br />( AUTHORIZATIQPI SIG ATURES <br /> UNLY TtlE OWNER OF T}IE PrtOPERCY OfYAN AtJTNORIZE[TAGENPMAY FILE AN APPLICATION <br /> I,the Owner/Agent agree,to defend,Indemnify,and [told harniless the County and Its agentsd,officers anemployees from any clalnt,action <br /> or proceeding against the Owner/Agent's project. <br /> I, further, certify under penalty of perjury that I ant(check one): <br /> ❑ Legal property owner(owner Includes partner,trustee,trustor,or corporate officer)of the property(s)Involved In <br /> this application,or <br /> Legal agent(attach proof of tite owner's consent to the application of the property's Involved fit this application <br /> and have been authorized to file on their behalf.,and that the foregoing application statements are true and <br /> correct. <br /> Print Name: 170 M44 shat/ Signature: Date: <br /> Print Nanle: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />