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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 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 l am(check one): <br /> f� Legal property owner(owner Includes partner, trustee, (rustor, or corporate officer) of the property(s) <br /> Involved in this application, or <br /> F _ . <br /> ❑ 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 Me on their behalf.,and that the foregoing application statements are <br /> true and correct. <br /> Print Name: Slgnature: <br /> G Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature. Date: <br /> Print Name: Signature: Date: <br /> f <br /> i <br />