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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 /> L <br /> r, certify under penalty of perjury that 1 am (check one): <br /> al property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> in this application, or <br /> al agent(attach proof of the owner's consent to the application of the property's involved in this <br /> ion and have been authorized to file on their behalf., and that the foregoing application statements <br /> and correct. <br /> Print Name: 642J'' � 114? Signature: Date: <br /> Print Name: Signature: Date: <br /> LPrinte: Signature: Date: <br /> e: Signature: Date: <br /> e: Signature: Date: <br />