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APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURE, <br /> ONLY THE OWNER OF THE PROPERTYYf3R;AN,AUTHORfZgD AVENT'MAYFILE,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 /> 1, further, 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 file on their behalf., and that the foregoing application statements <br /> are true and correct. <br /> Print Name: G {r�CA.Z <br /> // Signature: -,*,LDate: <br /> Print Name: l� Signature: Date: —/(e <br /> VV <br /> Print Name: L'J�/Q,�f r�� Fhb/ Signature: Date: - -d <br /> Print Name: Signature Date: <br /> Print Name: Signature: Date: <br />