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:'AUTHORIZATION SIGNATURES .. .' >: <br /> THE OWNER OF THE PROPERTY Ott AN AUTHORIZED AGENT MAY FILE AN APPLICATION <br /> I,the Owner/Agent agree,to defend.indemnify,and hold harmless the County and its agents.officers and employees from any claim, <br /> action or proceeding against the Owner/Agent's project. <br /> 1,further, certify under penalty of perjury that 1 am(check one): <br /> Legal property owner(owner includes partner,trustee,trustor,or corporate officer)of the property(s)Involved in this <br /> application,or <br /> Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and have been <br /> authorized to file on their behalf..and that the foregoing application ements are true a d correct. <br /> it Name: 5 , Tl]SD Signature: - Date: /0 2 <br /> C'hf, Es <br /> rt Name cr USS Signature Date: D- g7 <br /> it Name: Signatur Date: -S}y <br /> it Name. Signature: Date: <br /> it Name: Signature: Date: <br /> Approved By: Date: <br />