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APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES J <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 (lie County and its agents, officers and <br /> employees from any claim, action or proceeding against t/►e Owner/Agent's project. <br /> 1, further, certify undet penalty of perjury that I am (check one): <br /> ❑ Legal 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 (lie 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 /> Print Name: 7>��)( M j Signature: r - Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: _ Date: <br />