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JUN - 20 - 97 F= FFe 1 3 2 5 r - - - - f" 02 <br /> ;";0-- <br /> zjOIiN SACCONT,, R GON9 20995753138 eb-20-97 10:41 P.02 <br /> 2 <br /> APPLICATION w Sf7C APPROVAL <br /> + l .. ..• .: - -�.i• -w7ii�1�'ii Iia MA.A <br /> jjjjjg!jij 1111111 <br /> lrr riir OWN 1w1'� o_a xNdtttZO a4 w <br /> - - , .. LP. R �- f MTMAY� i�EIiN AAp <br /> �, the Owner/Agont agree, to 44fend,indemnify,end hold harmlese the County and its agsnks,officers and em l <br /> from any Nairn,action or proceeding *Oaihst the OwnerlAgeni's project, Payees <br /> furlhar, certify under penalty of perjury that I am(check one). <br /> Logal property owner Jownor includes partner.trpste8, <br /> ProPWMI)Itivolvad In thtrustor,or tdrparatto Officer)of the <br /> is application, Qr <br /> r7 Legal ag4nt(attach proof of the owner's conseht to the application of thern <br /> in this application and have been aythorized to file oh their behalf.,and tit t thdt f Y foregoing <br /> sgved <br /> spplicatJOA statements are true and correct, <br /> OfIni Narns, RANA _ +�I•,a {�.-��-�. f... <br /> Signature.a-- -- _ .�� wn,-.,raw•- •.. ..�... <br /> ..... ... pate: <br /> Parti Name. -` •-�.., ,,.., <br /> Date: <br /> PrintName, - <br /> »-�• <br /> Point Noma: Date: <br /> Signature: _ pate. f <br /> tr>int Noma: �....... <br /> r' '�-'-• .ar:s-•r-:sc -;rte•:��,� --�...-.-_.. -- -.. � ._._ .,�....., <br />