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APPLICATA __4 - SITE APPROVfAL <br /> AUTHORIZATION SIGNATURES <br /> r <br /> NLY 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 Owner/Agent's project. <br /> r, certify under penalty of perjury that I am(check one): <br /> al property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> d In this application, or <br /> LF-" 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: �� tJ _ Signature: Date: 7— r <br /> 0 <br /> Print Name: _ Signature: Date: <br /> Print Name: _ Signature: Date: <br /> Print Name: _ Signature: Date: <br /> Print Name: _ Signature: Date: <br />