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APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> Femployees <br /> THE OWNER-OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> r/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> from any claim, action or proceeding against the Owner/Agent's project. <br /> certify under penalty of perjury that I am (check one): <br /> property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> this application, or <br /> agent(attach proof of the owner's consent to the application of the property's involved in this <br /> appand have been authorized to file on their behalf., and that the foregoing application statements <br /> are true and correct.LLe <br /> /�(/��✓ M .%�A� Signature: ze6O Date:�aG4 ©E HENT �f�L<l>/AD�7 Signature �✓ )Date: fD .2(e—OvSignature: Date: <br /> Signature: Date: <br /> Signature: Date: <br /> .;�otaM 10 evert\�,. <br />