Laserfiche WebLink
APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER,OF THE-PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> f/, e Owner/Agent agree, to defend, Indemnify, and hold harmless the County and Its agents, officers and <br /> ployees from any claim, action orproceeding'agalnst the Owner/Agent's project. <br /> urther, certify under penalty of perjury that I am (check one); <br /> 0 Legal property owner(owner Includes partner, trustee, trustor, or corporate officer) of the p <br /> Involved In this appllcatlon, or roperTy(s) <br /> W 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 file on their behalf., and that the foregoing application statements <br /> are true and correct. <br /> PrintName: Donald ld. Oliver ,/ p <br /> Signature: �.�+.f� J ��r / Date:�l_t'�J <br /> Print Name; <br /> Signaturo: <br /> Print Name: Date: <br /> Signature: <br /> Print Name: Date: <br /> Signature: 4� <br /> PrJnt Nw�nrJ Do to: <br /> •lp�nw tures! �---- <br /> D�t.l <br />