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APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the OwnerlAgent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> employees from any claim, action or proceeding against the Owner/Agent's project. <br /> 1, further, certify under penalty of perjury that I am (check one): <br /> ® Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> ❑ 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 foregoing application statements <br /> are true and correct. <br /> Print Nam10-20-00 <br /> e: _ Randy Becker _ Signature: (t -c�t� / ,/yam Date: <br /> Print Name: Marie Becker J 10-20-00 <br /> Signature.,(LL 06 ,4 Date: <br /> Print Name: _ Signature: Date: <br /> Print Name: _ Signature: Date: <br /> Print Name: _ Signature: Date: <br />