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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, Indemnity, and hold harmless the County and Its agents, officers and <br /> employees from any clalm, action or proceeding against the Owner/Agent's project. <br /> 1, further, certify under penalty of perlury that I am (check on ) <br /> Z3 Legal property owner(owner Includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> Involved In this appllcatlon, or <br /> O Legal agent(attach proof of the owner's consent to the appllcatlon 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: JOHN FERRAIOLO Slgnatur .: �-"-�-D ��Da`tel1�21 0 2 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Dato: <br /> Print Namet aignaturai t7�1a1 <br />