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A <br /> f APPLICATION - SITE APPROVAL <br /> AUTHORIZA. UU '>SIGNATURES ...:::. <br /> ONLY THF-OWNER:OF THE:PROPERTY OR AN::AUTFfOR}ZED AGEIt1T.MAY:FILE.A-N -APPLICATION ... ;<h.... <br /> I,the Owner/Agent agree,tt defend,indemnify,and hold harmless the County and A agents,officers and employees <br /> from any claim,action or proceeding against the OwnerlAgent's project. <br /> I,further, certify under penalty of perjury that I am(check one): <br /> El Legal property owner(owner includes partner,trustee,trustor,or corporate officer)of the <br /> property(s) involved in this application, or <br /> Legal agent(attach proof of the owner's consent to the application of the property's involved <br /> in this application and have been authorized to file on their behalf.,and that the foregoing <br /> application statements are true and correct. } <br /> it <br /> Print Name: CURT HOFFMAN• Signature: Date: 1 1/2 4/9 7 <br /> Print Name: Signature: Date: J <br /> Print Name: Signature: Date: j <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> j <br /> E <br /> -s- <br />