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APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE'bWNEfi OF+:TH"E'PAbPERTY OR AN'AUTHORIZED AGENT MAY FILE AN 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 against the Owner/Agent's project. <br /> 1, furthor, certify under penalty of perfury that I am (check one): <br /> 0 Legal property owner(ownerIncludes partner, trustee, trustor, or corporate officer) of the property(s) <br /> Involved In this application, or <br /> MX 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 /> aro true and correct. <br /> Print Name: f Roa r8'_ Signature:/ �� Date: 11/26/02 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Do to: <br /> Print Noma: Signature: Deter <br /> PrT1 Nwmw, pip" to"# <br /> Owtq <br />