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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 /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees <br /> from any claim, action or proceeding against the Owner/Agent's project. <br /> I, 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 <br /> property(s) involved in this application, or <br /> YJ Legal agent (attach proof of the owner's consent to the application of the property's involved <br /> in this application and have been authorized to file on their behalf., and that the foregoing <br /> application statements are true and correct. <br /> Print Name: i L ZAhE:`P L. RUL);N CK Signature: I Q& Date: t,/iv/93 <br /> 1-PACIFIC E,�_2_.I, 4IPU ESS / <br /> Print Name: Signature: - Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />