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v .i <br /> APPLICATION - SITE APPROVAL <br /> AUTHORIZATIONSIGNATURES <br /> iONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENTMAY FILE AN APPLICATION;. <br /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees <br /> from any claim, action or proceeding against the Owner/Agent's project. <br /> I, further, certify under penalty of perjury that I am (check one): <br /> r Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the <br /> property(s) involved in this application, or <br /> Legal agent (attach proof of the owners consent to the application of the property's involved <br /> in this application and have been authorized to file on their behalf., and that the foregoing <br /> application statements are true and correct. <br /> Print Name: ERLINDA C. HERNANDEZ Signature: ' <br /> ate: /O <br /> Print Name: Signature: Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: Signature: <br /> Date: <br /> -5- <br />