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LAME <br />AUTHORIZATION SIGNATURES <br />ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAYFILE AN APPLICATION. <br />/,the Owner/Agent agree, to defend, indemn/ty, and hold harmless the Countyand Its agents, officers and employees from any <br />claim, action orproceeding against the Owner/Agent's proJect. <br />I, further, certify under penalty ofper)ury that I am (check one): <br />5!� Legal property owner (owner Includes partner ,trustee, "star, or corporate officer) ofthe pmperty(s) <br />Involved in this application, or <br />❑ Legal agent (attach proof ofthe owner's consent to the application ofthe property's Involved in this <br />application and have been authorized to file on their behalf) <br />and that the foregoing application statements are true and correct <br />Print Name: � Signature: Date: L,/Q4 <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />F.Wountain HouseLWHAppllcation FoMSVt4H-LA-ME Fahn-MASTER <br />EO <br />