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APPLICATION - SITE APPP?-OVAL <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> /, the Owner/Agent agree, to defend,indemnify,and hold harmless the County and its agents, officers and <br /> employees from any claim, action orproceeding against the Owner/Agent's project. <br /> I, further, certify under penalty of perjury that 1 am(check one): <br /> 0 Legal property owner(owner Includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> Involved in this application, or <br /> I7 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 are <br /> true and correct, <br /> Print Name: `/ Signature: f 221E. _ Date.. <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Nemo: signottirw; Detw; <br /> 1 <br />