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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 /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees <br /> from any claim, action or proceeding against the Owner/Agent's project. <br /> i <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 <br /> property(s) involved in this application, or <br /> I <br /> 7 Legal agent (attach proof of the owner's consent to the application of the property's involved <br /> in this application and have been authorized to file on their behalf.,and that the foregoing <br /> application statements are true and correct.. __ <br /> Print Name: Date•°?/I)JJe <br /> Print Name: �)/iii y (� (, ,, 1, c, .may Signature: Date: .,? - / 7-9� <br /> Print Name: LAva <br /> /( Signature: - Date: 17-1,2:ZL <br /> Print Name: VOA/-109 M Signature: U Gi '� Date•a �� !ted <br /> Print Name: Signature: Date: <br /> -n <br /> _g_ <br />