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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 or proceeding against the Owner/Agent'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 property(s) <br /> involved in this application, or <br /> EOI�Legal agent(attach proof of the owner's consent to the application of the property'involved <br /> statementin this s <br /> application and have been authorized to file on their behalf., and that the foregoing app <br /> are true and correct. <br /> �' Date: 3 O� <br /> Print Name! I�J� D��G� Signature- <br /> Print Name: Signature: <br /> Date: <br /> Da to: <br /> Print Name: Signature: <br /> Print Name: Signature: <br /> Date.'- <br /> Print <br /> ate:Print Name: Signature: <br /> Date: <br />