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APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES -� <br /> _ ONLY THE CWJNER 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 /> 1, further, certify under penalty of perjury that I am(check one): <br /> I Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> volved in this application, or <br /> L7 Legal agent(attach proof of the owner's consent to the application of the properiy's involved in this <br /> application and have been authorized to file on their behalf., and that the forelloing application statements are <br /> true and correct. <br /> `' I 23 <br /> Print Name: VV I I�-�/i rV� �� )��N s Signature: Data: <br /> Print Name: <br /> Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />