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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 /> f1the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agentsofficers and employees <br /> m 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 <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 I <br /> application statements are true and correct. <br /> Print Name: pohn 3�.'clL.11 � /�jfV7, Signature: _liw�� t „� �'1Q Date: z—122.1 1 <br /> � I <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: fl <br /> Print Name: Signature: Date: <br /> i <br /> Print Name: Signature: Date: <br />