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APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I, 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 OwneNAgent's project. <br /> 1, further, certify under penalty of perjury that I am(check one): <br /> ALegal property owner(owner Includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> nvolved In this application, or <br /> D 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 are <br /> true and correct. <br /> Print Name: K--Ur—'r PUI-LAEZ— Signature: Data: JULY /2 2!C; <br /> Print Name: Signature: Date. <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />