Laserfiche WebLink
APPLICATION - MINOR SUBDIVISION <br /> LAN JOd QUIN COUNTY CC3MN UNITY 4fELOPM NT DEPARTMENT <br /> ONLY THE OWNER OF T':PA0PVkTY.OR AN AUTi OR--EDAGE#T MAY FILE AN APPLICATION, .. <br /> 1.the OwngrlAgantagree,to defend,indemnity,and hold harmless the Cornrty and its agwAs,officers and employees from any claim,action <br /> ! or proceeding Against the OwneriAgent's project <br /> I,runr"r, oe'llty ander penalty of penury that l arra Jct eolk one), j <br /> r <br /> a <br /> Ell/ Legal property owner(wsrrer includes partner,tra tee,trssstor,or catpcWe ortker)Of the Pr er;.y{s}inuolyec m <br /> this application,or lj <br /> 0 Legal agent{attach proof of,the owner's consent to the appik4tion of the property's inmHret>n this application <br /> and have been authorized to Me on their kr"f.,and that ttaetor"oing application statements are true And <br /> correct <br /> Print Name; Patel W. �i,� Jr_ Signatctre L°. ,� �� Date: <br /> a <br /> Print Name: Signature: Cabe: <br /> Print Name,print Name* igttaiar'e: ,_.W.. Data: � <br /> i <br /> r <br /> Signature- D;'ttre: <br /> Print Namat: Signature: Date: <br />