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LOT LINE ADJUSTMENT <br /> clam A IN O NTY C MMUNITY DEVELOPMENT DEPARTMENT <br /> RE <br /> ONLY THE W ENTMAYFILEAN APPLICATION, <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 OwneNAgent's project. <br /> 1, further, certify under penalty of perjury that I am(check one): <br /> �f Legal property owner(owner Includes partner,trustee,grantor, or corporate officer)of the property(s)Involved in <br /> j \ 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/lie on their behalf.,and that the foregoing application statements are true and correct, <br /> Print Name: KP 11 in p I l Signature: Date: Ll-l S^-0 y <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Pi DEV9ER/I DARK/PI.IVIAPP9/LO LI HEADJAPPfom REV 2/1/99 -4- <br />