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APPLICATION - SITE APPROVAL }} <br /> I <br /> A UTHORIZA TION SIGNATURES <br /> :ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED°AGENT MAY FI1;E AN.APPLICATION. <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 procooding against the Ownor/Agent's project. <br /> 1, further, certify under penalty of perjury that l am (check one): <br /> D Legal property owner(owner Includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> involved in this application,or <br /> p Legal agent(attach proof of the owner's consent to the application of the property's lnvolved In this <br /> application and have been authorized to file on their behalf., and that the foregoing application statements <br /> are trueand correct. <br /> ✓/?? �J Yl Signature: r. ` Date. v� �r <br /> Print Nae:m - <br /> Print Name: Signature: Date: <br /> Print Name: <br /> Signature: Date: _ <br /> Print Name: Signature: Date: _ <br /> Date: <br /> Print Name: Signature. <br /> it <br />