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�1 <br /> i <br /> LOT LINE ADJUSTMENT <br /> SAN OA UIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> € ct� �""3 �` $'¢ s 9�;'y_'����il �o-°'�}e"',�a'•��ti:i77$$gg,.b,.� r!� , ;}6.?!f' a. ! .:;act <br /> F e�E- <br /> � s• #a alctq✓"-A{�.' P - a f9! 1.ti.3. ':,3»a3iqR -n ,S.rt A 3 Pa9R`xC3PEafy17Y�4R AICA'i-.. l.s €; <br /> "qi,�hI a1y.777 rOWNM"QFTNEORUb AGEkfLoA <br /> PP PCA77(JN�i a' 4 <br /> 1, the Owner/Agent agree, to defend, indemnify, 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,further,certify under penalty of perjury that l am(check one); I� <br /> XLegal property owner(owner includes partner, trustee, trustor, or corporate officer)of the prope�rrRty(sNE"Fmo <br /> )R t s <br /> 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 file on their behalf., and that the foregoing application statements are true and correct <br /> Print Name: f r Tr Signature: <br /> Date: -j= 43 <br /> Print Name: .,1 ^Sign . s „l."C <br /> tJ'k. <br /> Date: <br /> A Print Name: Lo LA Y'iSignature, f _ i` �r <br /> ,= g 'Cr_ . _!`r� I � �• c ��� Date: <br /> Print Name: 1 f��� - .�' Signature: <br /> ` /:_ f.•�! Date: .,) . <br /> Print Name: hate: <br /> �'Q t t' d� y/ <br /> ��. - Signature: �./f '4�I�� <br /> t'r_. r7�Q 1 <br /> M t 1V F. A51 Ire l r✓!'"��i! 'r-� . { I.�rf �` ��-c -� 71q/Q <br /> -- <br /> tce t eoz �1 <br /> fil <br /> I <br /> I <br /> r ,I <br /> :I <br /> I <br /> 4 <br /> I <br />