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APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER* <br /> OF THE,PROPERTY OR AN''AUTHOR/ZED`AGENT MAY FILE AN APPLICATION. <br /> I, the Owner/Agent agree, to defend, Indemnify, and Bold harmless the County and Its agents, officers and <br /> employvns from any c:lalm, actiun orproceoding,ag,,lnst the Owner/Age,it'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 property(s) <br /> s <br /> Involved In this appllcat/on, or Y( ) <br /> 0 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 appl/catlon statements <br /> are true and correct. <br /> Print Name: ~2�/S;,Q <br /> =---b[ �9L__ Slgnatur�: Date: <br /> Print Name: Slgnatu7 <br /> _re Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature: <br /> Print NAmel Date: <br /> S1gnatunr <br /> Datol <br />