Laserfiche WebLink
f <br /> APPLICAT1( - SITE APPROVAL <br /> - <br /> AUTHORIZATlON SIGNATURES <br /> ONLYTHEOWNER OFTHE-PROPERTY,t7R AN AUTHORIZED'AGENT MAY,FILE.AAI APPL1CA7701� <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 orproceeding against the Owner/Agent's project <br /> I,further, certify under penalty of perjury that I am(check one): <br /> Legal property owner(owner Includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> Involved 1n this application, or <br /> ❑ 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 rile on their behalf.,and that the foregoing application statements are <br /> true and correct <br /> Print Name Signature: <br /> -0/X/1/ Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name., Signature: Date: <br /> Print Name: Signature: Date: <br /> } <br />