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NA J 0 p Q n I COMMUNITY DEVELOPMENT DEPARTMENT <br /> N BUSINESS LICENSE <br /> COUNTY FILE NUMBER: 'SL ~I �1 <br /> FOR STAFF USE <br /> 9.2!LY <br /> Response Due Date: <br /> Business Information Applicant Information <br /> Business(DBA)Name: !k l;// Name: l: <br /> Mailing Address: 1,A 5'?2r ` Mailing Address: -- <br /> Phone: Phone: y — j f-- 4 LJ' <br /> Email: (�v,u� �D c iTJ�' Email: --- <br /> Property Information <br /> Assessor Parcel Number Property Address J City Cross Street <br /> Business Details <br /> Description of Business: j ., _— <br /> Type of Organization: Single Owner ❑ Partnership ❑Corporation ❑Other: —� <br /> Does the business include the sale of firearms? ❑Yes ❑No <br /> Number of Employees Hours of Operation Water Service Sewer Service <br /> Full Time j Part Time Public Private(on-site) Public Private(on-site) <br /> El <br /> AUTHORIZATION SIGNATURES <br /> I,the Owner/Applicant/Agent agrees to indemnify,defend(with counsel reasonably approved by County),and hold harmless the County and its officers, <br /> officials,employees,agents,boards and commissions(collectively"County")as follows: <br /> 1.INDEMNITY: <br /> A. From and against any and all claims,demands,actions,proceedings,lawsuits,losses,damages,judgments and/or liabilities arising out of, <br /> related to,or in connection with the application and applied for project or to attack,set aside,void,or annul,in whole or in part,an approval of <br /> the applied for project by the County,the adoption of environmental review documents related to the applied for project,and any related <br /> development approvals or project conditions for the applied for project(hereinafter"Claim"); <br /> B. For any and all costs and expenses incurred by the County on account of any Claim,except where such indemnification is prohibited by law, <br /> including but not limited to damages,costs,expenses,attorney's fees,or expert witness costs that may be asserted by any person or entity, <br /> private attorney general fees claimed by or awarded to any party against the County,and the County's costs incurred in preparing an <br /> administrative record which are not paid by the petitioner. <br /> C. Except as to the County's sole negligence or willful misconduct. <br /> 2.DEFENSE: <br /> A. The County may participate or direct the defense of any Claim.The County's actions in defense of any claim shall not relieve me of any <br /> obligation to indemnify,defend,and hold harmless the County. <br /> B. In the event of a disagreement between County and me regarding defense of any Claim,the County shall have the authority to control the <br /> litigation and make litigation decisions,including,but not limited to,the manner in which the defense is conducted. <br /> C. If I fail to promptly assume the defense of any Claim or to promptly employ counsel reasonably satisfactory to the County,then County may <br /> utilize the Office of the County Counsel or employ separate outside counsel to represent or defend the County,and I shall pay the reasonable <br /> attomeyss'fees and costs of such counsel. <br /> Print Name: 1� �1 '`� 4 �' Signature: Date: <br /> FOR STAFF USE ONLY A,� <br /> General Plan Designation: Zoning Designation: Use Type:/` e c. r-,t r i/•^ /V( c, < <br /> Department Approved Denied Signature Date <br /> CDD:Planning Division ✓ ^� <br /> Building Division <br /> Fire District: <br /> Environmental Health Department <br /> Department of Public Works <br /> MHCSD(if applicable) <br /> License approved for. <br /> A (is- (�6 - - <br /> History: <br /> Finalized by: Date <br /> 1 b(D9 Z1B S <br />