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LOT LINE ADJUSTMENT <br /> IN gQVUa UMMpf,�gL2PMENJD PARTMENT <br /> TURFSAU A <br /> 1, the Owner/Agent 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 X <br /> undpenalty of perjury that 1 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 /> O Legal agent(attach proof of the owner's consent to the application of the property's Involved In this appllcatlon and <br /> have been authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> �2 L <br /> ,�Q �-I/,e5T O .S®� Signature: Dat©: <br /> Print Name:,.L� V� <br /> Print Name: <br /> ,� CC1ss�" / Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> r,DC SER/IDARN/PWNAPP!/I LINP DJAPPMM RN 2/1/99 -4 <br />