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.� S <br /> LOT LINE ADJUSTMEN <br /> SAN,JOA IN COUNTY COMMUNITY DEVEL PMENT DEPARTME T <br /> A kORl2A t)N S GWA URE <br /> F ORIZED A FILE N P Li l N. <br /> 4 <br /> officers and employees from any claim,action or <br /> i' <br /> !,the Owner/Agent agree,to defend,lIndemnify,and hold harmless the County and its agents, <br /> proceeding against the owner/Agent's project. <br /> 1,further, certify under penalty of perjury that I am(check one): <br /> Le al property owner(owner includes partner,trustee,grantor,or corporate officer)of the property(s)Involved.In <br /> g <br /> this application,or <br /> !? _ O Lega!agent(attach proof of the owner's consent to the application of the property's Involved In this application and <br /> have been authorized to file on theft behalf.,and,that the foregoing application statements are true and correct <br /> 9�is cs 3 <br /> Signature: <br /> Date: <br /> Print Name: �N a�' <br /> Signature: Date: <br /> Print Name: l" <br /> Print Name: <br /> Signature: Date: <br /> !� 44 1 Date: <br /> Print Name: i Signature: <br /> '+ Date: <br /> Print Name: <br /> Signature: <br /> I�I <br /> II - <br /> 3 <br /> ii <br /> 1 <br /> �', <br /> ;i <br /> II <br /> 1 �I <br /> i. SEI <br /> I <br /> S� <br /> -9- <br /> MEVSEVIDARKIPLANAPPSILU'[LIN .IAPPFOPH REV 211!49 <br /> I . <br /> i <br /> i <br /> I <br /> 1 <br /> I __ <br />