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i <br /> APPLICATION MAJOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> PILE NO: MS- <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN .APPLICATION. <br /> t,the Ovlier/Agent agree,.to defend,indemnify, and hold harmless the County and its agents,officers and employees from any claim, <br /> actior.or proceeding against the County arising from the OwnerlAgent'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 /> Q <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 /> Print Name:,-.. Z2,h l4 #"�h -_ Signature � _. ;� Date <br /> Print Name: Signature: Date: <br /> Print Name Signature: Date: <br /> Print Narne: _ Signature: Date: <br /> j Print Name: _ Signature: Date: — <br /> F-tD--VSJSI.Planning;App6cationFo"s\MAJOR SUBDI`JISICN(Rev.05-11-09-9 ) Page 7 of 9 <br />