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APPLICATION - SITE APPROVAL <br /> AUTHORIZAT/ON SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. _ <br /> 1, the Owner/Agent agree, to defand, h;derMi;y, 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 /> l_ further,_ certify under penalty of perjury that l am (check one): <br /> L7 Legal property owner(owner Includes partner, trustee, trustor or corporate officer) of the property(s) <br /> Involved/n this application, or <br /> Vp Legal agent(attach proof of the owner's consent to the appllcat lon of the property's Involved In this, <br /> appllcatlon and have been authorized to file on their behalf., and that the foregoing application statements <br /> are true and correct. re <br /> PrintName: LFDuXQy $ CD. i1UC {-� <br /> Signature: / _ <br /> Print Name: Data: y <br /> Signature: <br /> Print Name: Date: <br /> Signature: <br /> Print Name: - Data: <br /> Sipnaturo: <br /> Print Nwmq Date: <br /> I/pnaura <br /> Pani <br />