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•p � /�+� ��-X75 -, <br /> LOT LINE ADJUSTMENT <br /> AN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> WIWORIMTION SIGNATURES <br /> Z D E LE <br /> 1,the Owner/Agent agree,to defend,Indemnify,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 I am(check one): <br /> O Legal property owner(owner Includes partner, trustee,grantor,or corporate officer)of the property(s)Involved In <br /> this application,or <br /> O Legal 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 8le on their behalf.,and that the foregoing application statements are true and correct. <br /> Edgar Lee Settlem re <br /> Print Name: ___ Y Signature: Date: <br /> Print Name: LM <br /> Cecil Marcell Dickens Signature: ���" -�� _ Date, 7-/Sr ' a� <br /> LPrIntName: Signature: Date: <br /> me: Signature: Date: <br /> me: Signature: Date: <br /> FZDW5ER/SSARK/PLANAPPs/LOT'LINFADJAPPMM RW 2/S/99 -4- <br />