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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 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 /> L7 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 We on their behalf., and that the foregoing application statements are <br /> true and correct. <br /> cDate: <br /> Print Name: A �1 ' 6� .�)n Il IZ Signature: t1+, rn "1 -- <br /> Print Name: �O ' O Signature: Date: <br /> Print Name: Ile T-1 <br /> ��Gfr� O!!L'�l Signature: Date: % U/ <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />