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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 OwnerlAgent's project. <br /> 1, further, certify under penalty of perjury that I am (check one): <br /> O 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 owners 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 /> PrintName: < �I�/)L j� S' f-�l�<F/` Signature: J,� F° f c . <br /> 03 <br /> Print Name: Signature: S-/9-15? <br /> [ L // Data: <br /> Print Name: 1� L, 1' S -p S-C/\ 1 . I - l-'1 Signature: -c=-�� �.4 �.F�-s'h Date:,5r/.�7.e <br /> i <br /> Print Name. Signature: Date: <br /> Print Namat I/yn�eurrtt Oath <br />