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���,'Yf : O��I U f I N A� COMMUNITY DEVELOPMENT DEPARTMENT
<br /> BUSINESS LICENSE
<br /> ---COUNTY
<br /> _. FILE NUMBER: f3c•-- 4L�Z'C'y7
<br /> Creatness grows here. Response Due Date:
<br /> FOR STAFF USE ONLY l
<br /> Business Information Applicant Information mac. LIJc-tJ
<br /> Business(DBA)Name_5AA 5�,c Name: N1u aP%4k1 ACI
<br /> Mailing.Address:. I1213-(p &u,�-t C I,- { Mailin1g Address: ,QpI'�
<br /> Phone. GAX-5�_ (oCl2 - Z(-1 _ _ Phone: L ,_ 2-1-1(,-
<br /> Email:
<br /> /1(vEmail: GI k MPu } A A u IGgL Email:
<br /> Property Information
<br /> Assessor Parcel Number Property AddreK City Cross Street
<br /> C r C,
<br /> Business Details
<br /> Description of Business: ��� a1 S e�
<br /> — -�-3------—�----- �--- ------------------
<br /> Type of Organization: ingle Owner ❑ Partnership ❑ Corporation ❑ Other.
<br /> Does the business include the sale of firearms? ❑ Yes D-No
<br /> Number of Employees Hours of Operation Water Service Sewer Service
<br /> Full Time Part Time Public Private(on-site) Public Private(on-site)
<br /> --- - _ ...- �a - to Po-\ ❑
<br /> NOTE:ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS.
<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,officials,
<br /> 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,related to,or in
<br /> connection with the application and applied for project or to attack,set aside,void,or annul,in whole or in part,an approval of the applied for project by the
<br /> County,the adoption of environmental review documents related to the applied for project,and any related development approvals or project conditions for
<br /> 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,including but
<br /> not limited to damages,costs,expenses,attomeys fees,or expert witness costs that may be asserted by any person or entity,private attorney general fees
<br /> claimed by or awarded to any party against the County,and the Countys costs incurred in preparing an administrative record which are not paid by the
<br /> petitioner.
<br /> C.Except as to the Countys 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 obligation to
<br /> 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 litigation and
<br /> 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 utilize the Office
<br /> of the County Counsel or employ separate outside counsel to represent or defend the County,and I shall pay the reasonable attorneys'fees and costs of
<br /> such counsel.
<br /> I,the Owner/Ap IicanUA a affirm all the information above is true and correct.
<br /> Print Name: M a Signature: Date: I
<br /> FOR STAFF USE ONLY
<br /> General Plan Designation: 61K Zoning Designation: C -I�, Use Type: S C,CMV7LAP-* tY\
<br /> Department Approved Denied Signature Date
<br /> CDD:Planning Division -(L�--
<br /> Building Division
<br /> Enforcement 'vision
<br /> Fire District/Warde :
<br /> Environmental Health Department
<br /> Department of Public Works
<br /> MHCSD(if applicable)
<br /> License approved for: e_4C,-_,ho c ��j-G--h�� w/l_�I "f�yY�l.tt'��t `� f �1�:;• �l� (1 ;v&
<br /> _l y'1 1Si� •�1.rLv_1.��C.�v?uv�� _.—.__..
<br /> History L' 1�.(�L'z%5'-(�L-13U-12`x'` l ...
<br /> 1. -U$Ci t�� �) - 2
<br /> Finalized by: f Date
<br />
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