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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 Ownor/Agont agree, to defend, Indemnify, and hold harmless the County and Its agents, officers And <br /> employees from any claim, action or proceeding against the Ownor/Agont's project. <br /> 1, further, certify under penalty of perjury that/am (check one): <br /> Legal property owner(owner Includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> ' Involvod 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 Elle on their behalf., and that the foregoing application statements <br /> are true and correct. <br /> Print Namo: �� �1� t^ ( Z Signature: <br /> --(�1�L� <br /> Data: <br /> Print Name: Signature: <br /> Data: <br /> Print Name: Y <br /> Z Signature: Date: <br /> Print Name: �� z_ Slflnaturo: <br /> Pr/"t Name# Da to: <br /> arpn.eu..� <br /> Decal <br />