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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 /> ffl, OwneNAgent 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/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 /> Ip, 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./ q— <br /> Print Name: �u�, {��y Signature: / Date: 1'1J') <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />