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APPLICATION - SITE APPROVAL <br /> l- '.e .-AUTHORIZATION SIGNATURES <br /> ;.ONLYYTHE't$L�I • EP DPE(2TYOR'ANAUTHORiZEDAGENTMAYFILEAN APPLICATION. <br /> 1, 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;agalnst the Owner/Agent's project. <br /> 1, further, certify under penafty of perjury that I am (check one): <br /> 4dx Legal property owner(owner Includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> Involved In this application, or <br /> O 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 f egoing application statements <br /> are true and correct. <br /> Print Namo: David Vaccarezza Slgnaturo: �� D❑to /6 O <br /> Pr/nt Nam a: Slgnaturo: Data: <br /> Print Nam a: Slgnaturo: Data: <br /> Print Name: Slgnaturo: Dato: <br /> Print Daly <br />