Laserfiche WebLink
APPLICATION - SITE APPROVAL <br /> - <br /> aU. wmAT sr�n�aruRFs <br /> ®NLy TF1E QWNER.t'1F 7'HE FROP.ERTY OR A•N A UTHDRREn, Q.EMT MA,Y 1 E AN ApPL,lC i4TJ4?N <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 /> 1 urther, 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) <br /> _��• involved i�this application, or. .- _ <br /> Legal agent(attach proof of.the owner's consent to the application of the property's Involved in this <br /> application and'have been authorized to rile on their behalf.,and that the foregoing application-statements are <br /> true and correct. <br /> Print Name: ` "` � Signature: _ Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> a <br /> 07) <br />