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APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> F7'employees <br /> HE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> rom any claim, action or proceeding against the Owner/Agent's project. <br /> ertify under penalty of perjury that I am (check one): <br /> roperty owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> his application, or <br /> �l Legal agent(attach proof of the owner's consent to the application of the property sinvllved statements <br /> in this <br /> application and have been authorized to file on their behalf., and that the foregoing application <br /> are true and correct. <br /> Lp1,� /,,� Date: —f I <br /> Print Name: �'IYk�'�. '�""�II4`""`' Signature: <br /> Date: <br /> Print Name: Signature: <br /> Print Name: Signature: <br /> Date: <br /> Date: <br /> Print Name: Signature: <br /> Print Name: Signature: <br /> Date: <br />