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A, <br /> v w�4rt <br /> LOT LINE ADJUSTMENT <br /> SAN OA U1N COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> crrr'r �F�aU�Tlir <br /> f�����"�f���, i �::arb�"9��'`7-r ��•���,� t � ' �. r <br /> !,the Owner/Agent agree, to defend,indemnt '�� �G'Et1iT ,y!„ ��$lit�.A/sPi =F1'�hf `�- ' "' <br /> fY,and hold harmless the County and its agents,officers and <br /> neentproject. employees,from any claim,action C ar proceeding against the Owr/Ag 's <br /> !.further,certify under penalty of perjury that 1 am(check one)-- <br /> ne)_Xx <br /> Legal property owner(owner includes partner,trustee,trustor,or corporate ojflcer)of the proper <br /> application,or ty(s)involved in this <br /> Lego!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 fore g in application statements are true and correct <br /> Print Name: �j�ri(�� Yf}JI <br /> Signature; � 4 0—?r— Date: <br /> Print Name: J I <br /> Print Name: t—�4•� ��� V <br /> Signature; <br /> Print Name: Date: L� Q <br /> Signature: <br /> Date: I <br /> Print Name: i <br /> Signature: <br /> Date: <br /> • 1 <br /> i <br /> r <br /> i <br /> k <br /> I <br /> I <br /> -4 ` <br /> a <br />