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APPLICATION - SITE APPROVAL <br /> aiy 1� ' <br /> . . . <br /> Y gg <br /> xk <br /> P!KT THE OWNER O„F THF PROPERTY O! gNAOThIORI�g- <br /> ' ,ENT MANY,FlL�,Ajlli AlftlGATIQN�„ <br /> 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> employees from any claim, action or proceeding against.the Owner/Agent's 'project. <br /> 1, further, certify under penalty of perjury that 1 am (check one): <br /> Legal property owner(owner includes partner, trustee, trustor, or corporate officer) offhe property(s) <br /> volved in this application, or I _, <br /> O Legal agent(attach proof of the owner's consent to the application of the property's Involved In this <br /> application and have been authorized to file on their behalf., and that the foregoing application statements <br /> are true and correct <br /> Print Name: 7F�C14 G. _83 q T,eS Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />