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' APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> i <br /> ONLY.THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE'AN APPLICATION.- <br /> iro­n <br /> e Owner/Agent agree, to defend,indemnify,and hold harmless the County and its agents, officers and <br /> OMP <br /> from any claim,action or proceeding against the ownerlAgent's project. <br /> urther, certify under penalty of perjury that 1 am(check one). <br /> Legal propertyowner(owner lncludes partner, trustee, trustor, or corporate officer) of the property(s) <br /> olved In this appllcatlon, or �Ly - Legal agent(attach proof of the owner'scsent 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 are <br /> true and correct .._ <br /> Print Name: • <br /> _Signature: Gti Date: <br /> SUSANNE M. QUAFWSM Signature: <br /> Print Name: ,- �. <br /> Signature: Date: <br /> Print Name. <br /> -�. _- r .: _ Date: <br /> Print Name:, Signature: - • •�— <br /> t <br /> Date:- y F. <br /> Print Name: = i Signature. —— <br /> I - .. -......„-. «,.,.,-........,, rte•--� r,. _.., . _ . .� _ . <br /> - <br /> . <br /> • r.y� T ap`t ry ` w.YY ^�.L '-. fr. } .: �- +�M .- "" ^ z • z. 1 ..4 w.W .�_ r <br /> - 3 <br /> -= . r <br />