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i . <br /> I ^ <br /> APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICA370N <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 1 am (check one): <br /> i <br /> -Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> involved in this application, or r _ <br /> D Legal agent(attach proof of the owner's consent to the application of the property's Involved in this w <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: /BE/�!/Y f30 Z ZECL p <br /> Y , Signature: ate: <br /> i <br /> Print Name: �E��A_ go ZZ EZ,e- Signature: Date:., <br /> i <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> I <br /> ^r, j <br /> 1t <br /> ti-9 I <br /> I <br /> I <br /> I <br /> i <br /> i <br />