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APPLICATION - SITL APPROVAL <br /> _ .ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED.AGENT MAY FILE AN APPLICATION. <br /> I, the O nmcr Agent agree to defend, inderfinify, and hold harmisss the Coo�!ity and its agents, officers and employees <br /> from any claim, ction or proceeding against the Owner/Agent's project. <br /> I,further, certify under penalty of perjury that I am (check one): <br /> a ❑ Legal'property owner(owner includes partner,trus'�ee,trustor, or corporate officer) of the <br /> rl� Legal agent (attach proof of the c.,vncr's consort tc Lie app:�cation of the pi�perty's i;,'volved <br /> in t o'bs application z.-n-e hive been authorized to ii',-: r,,i their behalf., and than the foregoing <br /> application statements are true and correct. <br /> Print Nan!-;: ) <br /> Signature:J A rra / <br /> Data: I o O <br /> Print Nacos: Signature: Date: <br /> Print Name;: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FODTHIU- LANDVILI- FkWECT <br /> -5- <br />