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f <br /> T <br /> APPLICATION SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE.OWNER,OF,THE,PROPERT.Y OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> Ap <br /> 1, the Owner/Agent agree, to defend, Indemnify,and hold harmless the County and Its agents, officers and <br /> F/ <br /> from any claim, action or proceeding•agalnst the Owner/Agent's project <br /> i <br /> 1, further, certify under penalty of perjury that 1 am (check one): <br /> Legal property owner(owner Includes.partner,p rtner, trustee, trustor, or corporate officer} of the property(s} <br /> Involved In this application, or <br /> J 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 We on their behalf,, and that the foregoing application statements <br /> are true and correct. <br /> 1 <br /> i <br /> Print Name: S (� <br /> V�� Signature: <br /> Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: ----� <br /> Signature: Date: <br /> Print Name. -----�— <br /> Signature: Date: <br /> Print Nw►nrr <br /> i <br /> r , <br /> � I <br /> - f <br /> E <br /> q <br /> - j <br />