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APPLICATION - SITE APPROVAL <br /> ragenA OTHORIZA TION SIGNATURES <br /> t <br /> Y THE OWNER OF THE PROs ERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> er/Agent agree, to defend, Indemnify, and hold harmless the County and Its agents, officers and <br /> s from any claim, action or proceeding against the Owner/Agent's project, <br /> certify under penalty of per that[am (check one): <br /> l property owner(owner Includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> n this appllcaflon, orl agent(attach proof of the owners consent to the application of the property's Involved In this, <br /> n and have been author/zed to Me on their behalf., and that the foregoing application statements <br /> are true and correct. <br /> Print Name: / oK Signature: <, <br /> p L <br /> Print Name: r L� Glct Slgnatura: OL <br /> Date: <br /> � Date: 11 OL <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature: Date: <br /> Print Name; <br /> 9lgneturet Date; <br /> it <br /> i <br />