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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 /> 1, the Owner/Agent agree, to defend, Indemnify, and hold harmless the County and Its agents, officers and <br /> employees from any claim, action orproceeding'against the OwneNAgent's project. <br /> I, further, certify under penalty of per)wy that 1 am (check one): <br /> I <br /> O Legal property owner(owner Includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> Involved In this application, or <br /> i <br /> Legal agent(attach proof of the owner's consent to the application of the property's Involved In this, <br /> lippllcatlon and have been authorized to file on their behalf., and that the foregoing application statements <br /> are true and correct. <br /> Print Name: •7 . %� . Signature:/i ! /i. Date:/_L, e; <br /> Print Name: 3- �� �� Signature. Date: �p�—O�• <br /> RE ,e!ve <br /> Print Name: Signatyre: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> I <br /> i <br /> i <br /> I <br /> I <br /> I <br /> I <br />