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u <br /> ' <br /> w' <br /> 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!am{check one}: <br /> ❑ Legal property owner(owner Includes partner, trustee, trustor, or corporate offic6r) of the property(s) <br /> involved In this application, or <br /> p . 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 <br /> are true and correct. <br /> Print Name: 111 <br /> Signature. Date: G � <br /> Print Name: <br /> Signature: Date' <br /> Print Name: <br /> Signature: Date: <br /> Print Name: Signature: Date:_ <br /> Print Name: <br /> Signature: Date: <br />