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APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the OwneNAgent agree, to defend, IndemnIty, 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/am (check one): <br /> W Legal property owner(owner Includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> Involved/n 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 app/!cation statements <br /> are true and correct. <br /> PdntName: 3. cxcgG ) S Signature: , <br /> Date: 08-27 Oz <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature: <br /> Dato: <br /> Print Name: Signature: <br /> Print Namet Date: <br /> SIgnstur.r <br /> Doty <br />