Laserfiche WebLink
,• ,.,moi`;. . <br /> APPLICATION - SITE APPROVAL ". ` <br /> A(1THORIZATION SIGNATURES .:> ... <br /> k , <br /> ONLY THE.OWNER:OF T'HE'PROPERTY OR` # <br /> AN AU.THORIZI=II:AGEI�IT..MAY'I=ILEAN.APPLICATIQN......:. .... ..:< <br /> I, the OwnerlAgent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees <br /> from any claim, action or proceeding 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 . <br /> property(s) involved in this application, or <br /> ❑ Legal agent (attach proof of the owner's:consent to the application of the property's involved i <br /> in this application and have been authorized to fil on 0-it behalf.,and that the foregoing } <br /> application statements are true and correct. <br /> Print Name: Steven M Jones Signatur Date: <br /> i <br /> Print Name: Signatur Date: <br /> Print Name: Signature: Date: <br /> Print Name; Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> r <br /> W <br /> f <br /> Y r <br /> 4 ' <br /> 1 <br />