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APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the OwnerlAgent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> 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 /> YLegal property owner(owner Includes partner, trustee, tnistor, or corporate offlc,)r) of the property(s)involved in this application, or <br /> 0 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 are <br /> true and correct <br /> Print Name: / �i�'/1� ! s Signature: .tc t 9" �/ Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name,, Signature: Data: <br />