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MAP f28-2002 02: 19 PM MIKE SMITH ENGINEERING 209 334 0102 P. e2 � <br /> Ar <br /> APPLICATION - SITE APPROVAL <br /> -AUTHORIZATION SIGNATURES <br /> ONLY YHP OWNER QF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APP14CA770hl. <br /> 1, the OwnerlAgant agree, to defend,Indemnify,and hold harmless the County and Its agents,Afflcary and <br /> employees from any claim, action or proceeding against the OwneNAgenf's project <br /> 1, further, certify under penalty of perjury that i am(check are): <br /> ❑ Legal property owner(owner Includes partner,trustee, trustor, or corporate ofltrar)of the propao(s) <br /> Involved In this application,or <br /> AM 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 thslr behalf,and that the foregoing application statements <br /> are true and corract <br /> BRIAN J.'. 3/29/02,ROEK f <br /> PrintName; Slynature: Date: <br /> Pdinr Name: 5lyrturo: Date: <br /> Print Name: Signature: Dara:-.-- -.-._-- <br /> Pr►ntName: signature ��. _ Date: <br /> Print Name: Signature; Cate: <br /> s , <br />