Laserfiche WebLink
%.•',..i.:+.. �. I R EJ L7i I!' R 3 i!F-1&A _ Rfii Ri! 7!J Qi 131_1 lilll'`1! lR1 I <br /> SAN .1r)Ant IIN nnl i-TY rnm-A INITY nrvr:i nPMFNT nFPARTMFNT I <br /> 1 <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I, the OawnedAgenl agree,to defend, Indemnlfy, and hold hairless the County and Its agents, officers and employees from any Galm, <br /> action or proceeding against the Owner/Agent's project. <br /> I further certify, under penalty of perjury, that 1 am (check one): <br /> �j Legal property owner(owner includes partner, trustee, grantor, or corporate officer) of the property(s) involved in this <br /> \ application, or <br /> ❑ Legal agent(attach proof of the owners consent to the application of the propertys involved in this application and have been <br /> authorized to file �'�le on their behalf., and that the foregoing application statements are true and correct. <br /> Print Name: 41LI-6 C(L- GAl A Signature: 'rem Date: /�-16`�� <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />