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If` i1 <br /> I it i� <br /> M LOT LINE ADJUSTMENT <br /> SAH JOAQt11N COUNTY COMMtJmTY DEVELOPMENT DEPARTMENT <br /> AUTHORIZATION S1GN 4TIlRES <br /> QNLY THE OWNER OF THE PROPERTY QR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> li � <br /> o the Owner/Agent agree,to defend,indemnify,and hold harmless the County and Its agents,officers and employees from an <br /> orpnoceeding against the Owner/Agents proJecL <br /> �i Y claim,action <br /> 11 further, certify underpenally of e u that I am(check one): <br /> Y Airy i <br /> �j Legal property owner{owner includes partner,trustee,trustor,or corporate officer)of the pro ert s Involved in this <br /> application,or A YO <br /> O Legal agenf(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 their behalf.,and that the foregoing application statements are true and correct. <br /> i <br /> it <br /> li <br /> Print Name: o 14 C <br /> Z al <br /> � Signature: <br /> PrintName: /e �4 <br /> Date: <br /> Ii <br /> Signature Date: 9 -/9- 00 <br /> Print Name: <br /> Signature: Date: <br /> Print Name: <br /> - <br /> II Signature: <br /> Print Name: Date: <br /> `' Slgnafure: ~� <br /> it �I Date: <br /> ij <br /> fi <br /> II <br /> i° <br /> li I�I; I <br /> it <br /> I� <br /> k <br /> I <br /> II <br /> I <br /> I <br /> I <br /> .i <br /> . E <br /> II II <br /> I y ` <br /> ii <br /> I <br /> I <br /> u � <br /> t:i1 PFAPAJAYC February mopq <br /> 1 -4- <br />