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LOT LINE ADJUSTMENT <br /> EN <br /> i <br /> 1,the OwnerlAgent agree,to defend,indemnity,and hold harmless the County and Its agents,officers and employees from any claim,action or <br /> proceeding against the Owner/Agent's project, <br /> 1,further, certify under penalty of perjury that!am(check one): <br /> Legal property owner(owner Includes partner,trustee,grantor,or corporate officer)of the property(s)Involved In <br /> this application,or <br /> 0 Legal agent(alta 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 their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> t <br /> r ozvscalxwax/rwurre/u�r�xMcwyarrrorx wv x/x/ff —4— <br /> 1 <br />