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Asp 6Cz- HOME OCCUPATION <br /> .-,RE "IEVED COMMUNITY DEVELOPMENT DEPARTMENT <br /> EP <br /> 5 SI-P i 8 20C18 BL APPL. NO: 131- <br /> r7� <br /> unity ISevelop <br /> /irk <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 employees <br /> from any claim, action or proceeding against the Owner/Agent's project. <br /> 1,further, certify under penalty of perjury that I am (check one): <br /> Legal property owner(owner includes partner,trustee, trustor, or corporate officer)of the property(s)involved in this <br /> application, or <br /> El Legal agent(attach proof of the owner'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 /> Signature: Date:Print Name: -84014 4JA7-r0S inature: �- <br /> Print Name: J Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> STAFF USE ONLY <br /> G/P Designation: t Zoning: APN: <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services Planner Name: E-7. 4aZt <br /> Building Inspection <br /> Fire District <br /> Environmental Health Div <br /> Public Works Department <br /> M.H.C.S.D. <br /> License Approved For: <br /> 15 <br /> Remarks: + <br /> -1 <br /> Accepted as Complete: Date: <br /> F:\DEVSVC\Planning Application Forms\Home Occupation.doc. Page 4 of 4 <br /> (Revised 03-12-08) <br />