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APPLICATION - ;SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER'OF THE PROPERTY OR 4N'AUTHORIZED AG ENT MAY F/LEAN APPLICATION. <br /> 1, the Ownerrom a agree,claim, <br /> , ctiodefend, Indemnify, and hold harmless the County and Its agents, otticers and <br /> employees from any claim, action or proceeding'agalnst the OwnerlAgent's project. <br /> 1, further, certify undor pone/ty of perjury that I am(check an <br /> 'X Legal property owner(owner Includes partner, trus <br /> Involved In this application, or tee, trustor, or corporate officer) of the property(s) <br /> 0 Legal agent(attach proof of the owners consent to the application of the property's Involved/n this <br /> application and have been authorized to 1710 on theirbeha/f.,and that tit <br /> are true and correct. s foregoing appllcatlon statements <br /> Print Nemo: -DgYC — <br /> Signature: <br /> Print Name: dELI A L�NFJ�FT� 17r�I[/[rj i Date: <br /> Signature: Q <br /> Print Name; Date: <br /> Print Name: Signature: <br /> Data: <br /> PNnf Nerner <br /> Signature: '---- <br /> alanawrvr ------ ----� Date: <br /> . iYllilCn: %o•j <br /> 11 <br /> 1A <br /> i: ., r <br />