Laserfiche WebLink
SITE IMPROVEMENT PLAN <br />SAN -10A Ul ___. ......... _._. —.. ...—... <br />AUTHORIZATION SIGNATURES .. <br />ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPUCATION. <br />I. the Owner/Agent agree, to defend, Indemnify, and hold harmless the County and its agents, officers and employees frorn any cialm, action or <br />proceeding against the Owner/Agent's project <br />I. further, certify under penalty of perjury that I am (check one): <br />0 Legal property owner (owner Includes partner. trustee, trustor, or ,ate officer) of the property(su Imrolved In this <br />application, or <br />X.1 Legal agent (attach proof office corner's consent to the application of the property's involved in this application and <br />have been authorized to file on their behalf., and that the foregoing application statements are true and correct, <br />Print Name: ic 1(.05.EC SignatUre: ------1-7,-C6' KIP--e---"---- Date: <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />._