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APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> [rtl,ti <br /> LY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> ner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> es from any claim, action or proceeding against the OwnerlAgent's project. <br /> r, certify under penalty of perjury that l am (check one): <br /> al property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> in this application, oral agent(attach proof of the owner's consent to the application of the property's involved in this <br /> on and have been authorized to file on their behalf., and that the foregoing application statements <br /> nd correct. <br /> Print Name: L r; W. W oo Jv V-F1_ Signature: Date: 91 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> I <br />