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APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> i 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,f rther' certify under penalty of perjury that l am(check one): <br /> Legal property owner(owner includes partner,trustee,trustor,or corporate officer)of the property(s) <br /> nvolved in this application,or <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 file on their behalf.,and that the foregoing application statements <br /> are true and correct. <br /> Print Name: �G�1`1a �. PGVC•C Signature: �f /� 1 Date:f�(s�a� <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />