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LOT LINE ADJUSTMENT <br /> SAN OA UIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1,`the Owner/Agent agree,to defend,W mnlfy,and hold harmless the County and its agents,officers and employees,from any claim,action <br /> or proceeding against the Owner/Agent's project. <br /> 1 n . <br /> 1,further,certify under penalty of perjury that l am(check one): <br /> X Legal property owner(owner includes partner, trustee,trustor,or corporate officer)of the property(s)involved in this <br /> `i application,or '� <br /> Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and have <br /> been authorized to fele on their behalf.,and that the foregoing application statements are true and correct <br /> w <br /> Print Name: r, o�� "Signature I r <br /> Il +y Pi At Date: L 1 QJ <br /> Print Name- P) l .66Sa4aature <br /> Date: <br /> Print Name: _ Signature: Date: <br /> Print Name: Signature: Date: <br /> €! <br /> Print Name: Signature: <br /> Date: <br /> €I ' <br /> i; <br /> ,h <br /> ;i <br /> i <br /> I <br /> .i I <br /> i <br /> A i <br /> ! <br /> F 4_ <br /> f <br /> is <br /> i <br />