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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 /> /, the Owner/Agent agree, to defend, Indemnify, and hold harmless the County and its agants, officers and <br /> employees from any claim, action or proceeding.'rgalnst tlzo Uwrtorl'.4gonYs protect. <br /> �l, fur�th r, certify under penalty of perjury that/am (check one): <br /> �' Legal property <br /> P y owner(owner Includes partner, trustee, trustor, or corporate officer) of tho property(s; <br /> Involvod In this application, or <br /> L7 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 appllcatlon statements <br /> are true and correct. <br /> Print Name: /, � - <br /> Signature: <br /> Print Name: Date: - _o L <br /> Slgnaturo: <br /> Print Name: Date: <br /> Signa tura: <br /> Print Name: Dato: <br /> Print Name, Slgnaturo: <br /> aJpn�tur�i Dato: <br /> Decal <br />