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4 E 1 <br /> LOT LINE ADJUSTMENT <br /> SAN JOA UIN CdUNTY COMIYIUNITY DEVELOPMENT AEPARTMENT <br /> AUTN lZATf SI NATURE <br /> LYTHE OWE F E P RT A U ED T M tLE P L T O <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 /> i <br /> 1,further, certify under penalty of perjury that!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 application'and <br /> have been authorized to file on their behalf.,and that the f going application statements are true and correct. <br /> Print Name: L Cil W r rice <br /> Signature: � Date: <br /> Print Name: L i 8 K' i L e- Signature: Date: Cl— <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: <br /> Signature: Date: ' <br /> i <br /> i <br /> I <br /> i <br /> F:DEVSEFt/IDARA/PLANAPPS/LD9'LINEAD.IAPPFDFM REV 2/1/99 -4- <br />