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LOT LINE ADJUSTIE17FNT <br /> SAN JOA COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUTHORIYATIOIV SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGEN T MAY FILE AN APPLICATION. <br /> 1,the Owner/Agent agree,to defend,Indemnify,and hold harmless the County and its agenfs, officers and employees from an <br /> or proceeding against the Owner/Agent's project.' <br /> y claim,action <br /> 1,further, certify under penalty of perjury that I am(check one): <br /> O Legal property owner(owner Includes partner, trustee, trustor, or corporate officer)of the property(s)involved In this <br /> application, or <br /> O Legal agent(attach proof of the owner's consent to the application of the property's Involved In this application <br /> have been authorized to rile on thelrbehalf, and torrect. and <br /> that the <br /> foregoing application statement <br /> s are true and correct: <br /> k r n <br /> Print Name: _� } e ��`— _r_Li P. <br /> LJ`- �-a Signature: /,� ���A^ <br /> Print Name: Date:' J <br /> Signature: <br /> Print Name: ! Dale: <br /> Signature: <br /> Date:-Name: ---`_ <br /> ` Signature: <br /> Date: <br /> Print Name: t <br /> Signature: <br /> Date: <br /> ' i t <br /> r <br /> F <br /> f. <br /> r ,-.c z ..;Y.._.. .. w. -:.-.ri:.r�- .:=.tea. �� w-.�r.,.�..n,r..w -»i •:-�,.! xrw�r•.ws ye.�:: ,w. .. t--�--�. <br /> 1:41 PMPkLA9E FeWvary 1,1999 <br /> -4- <br />