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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 /> 1,further, certify under penalty of perjury that/am (check one): <br /> e Legal property owner(owner Includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> Involved In this application, or <br /> O 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 /> t- � <br /> Print Name: C �o T y Signature: ,i ' Date: - e-02 <br /> Print Name: Signature: Date: Ib -I0 -OZ <br /> Prin[Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Namet •tpnatumt Dater <br />