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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 /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees <br /> from any claire, action or proceeding against the Owner/Agent's project. <br /> I, further, certify under penalty of perjury that I am (check one): I <br /> I_I Legal property owner(owner includes partner,trustee,trustor, or corporate officer) of the i <br /> / property(s) involved in this application, or I <br /> l�1 Legal agent (attach proof of the owner's 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: /3/GX-fe 16ieG� Signature: z�� _ Date: <br /> Print Name: Signature: Date: _ <br /> Print Name: Signature: Date: _ <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />