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APPLICATION - SI TE APPROVAL <br /> AOTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PRO�ERTY:OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, the OwnerlAgent 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 /> 1, further, certify under penalty of perJpry that I 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 /> 4f 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 /> Print Name: Steven A. M a 1 c o u n Signature: 'S °�t'''ti `�Ge'L�-- Date: 7 .- <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: _ <br /> ,Print Name: Signature: Data: <br />