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FEB-21-2001 1101 PINNACLE SYSTEM P.02/04 <br /> V1 nnu 1V•JU rLn V m 11 1 VVlll1Y111:, riLA: 1V1jou0V0L Fl11rL L <br /> `w <br /> APPLICATION - SITE APPRO 1/AL. . <br /> w AUMOR1zATIoN SIGNATURES <br /> ONLY THE OWNER OF TPfE PROPERTY OR AN AUMOR17ED AGENT MAY FILE AN APPLICATION. <br /> !, the Owner/Agent agree, to dofond,indemnify, and hold harmless the County and its agents, officers and <br /> Cmp/ogees from any claim,action orproceedlng against the Owner/Agent's project. <br /> 1, further, certify under penalty of perjury that lam(check one): <br /> Legal property owner(owner includes partner, trustee, trustor, orcorporate officer) of the property(s) <br /> involved in this application, or <br /> i <br /> © Legal agent(attach proof of the owners consent to the application of tho 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, 9 g PP <br /> Print Name: u—L-A I Signature: <br /> ____r_ _ Date: <br /> 1 Print Nartrc_ _ signature_ <br /> Date: I <br /> Print Name: � +e_2 Signature. <br /> Date: A/o/ <br /> Print Noma: _ Signatura: <br /> Date: <br /> I Print Nanta. <br /> T, Signature: Date: <br />