Laserfiche WebLink
APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the Owner/Agent 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 /> 1further, certify under penalty of perjury that I am(check one): <br /> ®/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 owner's consent to the application of the property's involved in this <br /> application and have been authorized to We on their behalf., and that the foregoing application statements are <br /> true and correct. � r' o <br /> Print Name: MF� RiVl A4 Signature Dater Z j <br /> Print Name: FAAV k-04 M Signature: f Date: �3 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />