Laserfiche WebLink
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 or perjury that/am (check one): <br /> XLegal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> 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 /> �/ l O <br /> Print Name: �E-�-�� u� ")1ZGi.qer Signature: <br /> Print Name: '(�(�( 1(� L)j_( Signature: Date: <br /> Print Name: Signature: r Date: <br /> Print Name: C��.k � i f � j� Signature: r Date: <br /> Print Name: Signature:' Date: <br />