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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 Owner/Agent 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 /> Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> 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 /> � Y <br /> Print Name: C). �' <br /> Signatur a Date:__ <br /> Signature: date: <br /> Print Name: <br /> Print Name: <br /> Signature: Date: <br /> Print Name: <br /> Signature: Date: <br /> j Print Name: <br /> Signature: Date: <br />