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APPLICATION - SITE APPROVAL <br /> AUTHORIZATION SIGNATURES <br /> F <br /> NLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> ner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> empoyees from a..r1y claim, action or proceeding against the Owner/Agent's project. <br /> 1, further, certify under penalty of perjury that 1 am(check one): <br /> 0 Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> Legal yan;(atraci, n-0 of the ov!�ners 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 applicati7q- <br /> nts are <br /> true and correct. <br /> �/ch�L�� fscn Signature: Date: L-D <br /> Print Name: _� / <br /> Date: �3 " <br /> Print Name: P/✓i4dSignature: <br /> s a.✓ <br /> Print Name: <br /> Signature: Date: <br /> Print Name: <br /> Signature: Date: <br /> Print Name: <br /> Signature: Date: <br />