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' L�T LINE ADJUSTMENT <br /> SAN <br /> 'Mu <br /> auriolz►zanoly saNATrll�as ;x <br /> � f?IYLYTHgOWNM7GF7HL�.�PR�OP�RT1'OFt%1H/1U7HGW,ZEDAG�NTMAYl=ll.gaN"AP'ALK`AT70N <br /> 'G Owner/agent agree,to defend,Indemnify,and hold harmless the County and its agents,officers and <br /> rceeding against the OwnedAgent's project 00100085 from any claim,action or <br /> rl� rther, cerllfy under penalty of perjury that I am(checlk on <br /> Legal pmperty owner(owner Includes partner,trustee,trustor,of co prate office <br /> application,or rP n of the AmAerty(s)lnvolved In this <br /> Legal agent(attach proof of the owner's consent to the application of the property's Involved In this application and have <br /> {k? been authorized to file on theft behalf.,and that the foregoing application statements ata <br /> true and correct <br /> int Name: <br /> Date: <br /> Signet <br /> nt Name: <br /> s <br /> Sig to Date: <br /> +�`-11ntName: FQdXd � Signature: <br /> ; ,,. <br /> �,'J_ �6�+{LQDate: <br /> sf F�int Name: l� <br /> ;, f Signature: Date: <br /> fnt Name: roe— !�C Signature: <br /> Date: <br /> ia�,� <br /> ry� <br /> Vii'moi'W. <br /> W I�. <br /> e <br /> Ei s 3, <br /> KpC2', <br /> 3 <br /> Hi <br /> 0r{ r <br /> {•paw-}I,: <br /> ��tl Et <br /> vq <br /> Y(t{ <br /> }ii�'y:uti3' <br /> 15 <br /> f I <br /> 3 <br /> .` 10:03 AMPA-LA06 FebriM 1.1= <br /> k'. <br />