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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 /> I, 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 OwnerlAgent's project. <br /> I, 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 <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. 1/ <br /> Print Name: iYI, L/.� .�. !f`.E"Z'Y Signature: Date: g Y <br /> Print Name: JJ�AL�/ ��jp/GUE Z Signature:, Date: 4/ �- y <br /> Print Name: ,-112W&,yt 26 Signature: Date: S" <br /> Print Name:/' ,,Wr771 �� �C �/ 7 Signatur L'��� -'V- Date: `F!-5- <br /> Print <br /> Print Name: Signature: Date: <br /> _c_ <br />