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APPLICATION - SITE APPROVAL <br /> .-AUTHORIZAT16N.'SIGNATURES <br /> C)NLYTHE OWNER OF THE PROPERTY:'OR.AN gU,THDRIZED AGENT MAYFILE AN APPL1tAFlON <br /> i, the Owner/Agent agree, to defend, Indemnify, and hold harmless the County and Its agents, officers and <br /> employees from any claim, action or proceading'against the Owner/Agent's project. <br /> —.1, further,_ certify under penalty of perjury that l am(check one): <br /> _ _ <br /> LZ Legal property owner(owner Includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> Involved In this application, or <br /> 17 Legal agent(attach proof of the owner's consent to the application of the property's involved In thls, <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: Signature: , 2Date: 5/3/02 <br /> Print Name: Katherine M. Robello Signature: 'A- ADate: 5/3/02 <br /> Print Name. Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Data: <br /> I <br /> I <br /> s <br />