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LOT LINE ADJUSTMENT <br /> N A INC UNTY C MMUNITY DEVE OPMENT DEPARTMENT <br /> A T ZA AT <br /> ONLY THE QWBER OF THEP P T MAY Fit E AN APPLICA <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 /> 1, further, certify under penalty of perjury that I 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 /> Print Name: kL9- t, <br /> have been authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> r =PD L i3A - Osignature f� Date: 3-2'1-06 <br /> _ <br /> Print Name: <br /> JAS/FT r3Ct2T�� s/tan.rura: _ Date: <br /> Print Name: J?f2 �E FiAtI signature: Data: 3-2Y-ob <br /> r n Ac£- PAA--r-Q-4 signature: Date: 3-21"O(o <br /> Print Name: Date: 3-27-04 <br /> �j � -t' 1 �Ignature: "' <br /> Print Name: - - -06 <br /> C�� l A4 r? <br /> n ucvecx/mMK/NJlnrv5/A L'WMWA""W1 nev 211/99 <br />