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APPLICATION - SITE APPROVAL <br /> AUTHORlZA TlDN:SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the Owner/Agent agree, to defend,indemnify, and hold harmless the County and its agents, officers and <br /> t employees from any claim, action or proceeding against the Owner/Agent's project <br /> 1, further, certify under penalty of perjury that I am (check one): <br /> E <br /> L7 Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> involved in this application, or <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 /> Nam f" !� Signature: Date: e 6 <br /> Print N <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature; Date: <br />