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APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> rL7Legal <br /> THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> r/Agent agree, to defend, Indemnify, and hold harmless the County and Its agents, officers and <br /> from any claim, action orproceeding against the OwneNAgent's project. <br /> certify underpenalty of perjury that I am (check one): <br /> property owner(owner Includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> this application, or <br /> gent(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 /> Print Name: , ���`j/_-S� Z- Fr Signature: ..� - <br /> Data: y"Z 3 �C <br /> Print Name: Signatu <br /> Data: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature: <br /> Date: <br /> Pr/n1 NITI/ I/pnalura/ <br /> Dahl <br />