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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 1 am(check one): <br /> O Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> O 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 are <br /> true and correct. <br /> Print Name: `1 C- L L) l,-d c- Signature: Date: l l k o <br /> Print Name: -�. `e L c m r1 Signature: c- A 1 Date: c° <br /> Print Name. Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> :r <br />