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SA N.r,JOAO U IN COMMUNITY DEVELOPMENT DEPARTMENT
<br />-COUNTY-\
<br />FILE NUMBER:
<br />AUTHORIZATION SIGNATURES
<br />ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAV FILE AN APPLICATION
<br />I, the Ovlner/ApplicantlAgent agrees to indemnify, defend (with counsel reasonably approved by County), and hold
<br />harmless the County and its officers, officials, employees, agents, boards and commissions (collectively ncountf) as
<br />follows:
<br />1.INDEMNITY:
<br />A. From and against any and all claims, demands, actions, proceedings, lawsuits, losses, damages,
<br />judgments and/or liabilities arising out of, related to, or in connection with the application and applied for project or to
<br />attack, set aside, void, or annul, in whole or in part, an approval of the applied for project by the County, the adoption of
<br />environmental review documents related to the applied for project, and any related development approvals or project
<br />conditions for the applied for project (hereinafter "ClaimN); B. For any and all costs and expenses incurred by the County on account of any Claim, except where such
<br />indemnification is prohibited by law, including but not limited to damages, costs, expenses, attorney's fees, or expert
<br />witness costs that may be asserted by any person or entity, private attorney general fees claimed by or awarded to any
<br />party against the County, and the County's costs incurred in preparing an administrative record which are not paid by the
<br />petitioner.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 o� any Claim. The County's actions in defense of any
<br />claim shall not relieve me ri any obligation to indemnify, defend, and hold harmless the County. B. In the event of ai disagreement between County and me regarding defense of any Claim, the County shall
<br />have the authority to control the litigation and make litigation decisions, including, but not limited to, the manner in which
<br />the defense is conducted. C. If the County reasonably determines that having common counsel presents such counsel with a conflict of
<br />interest, or if I fail to promptly assume the defense of any Claim or to promptly employ counsel reasonably satisfactory to
<br />the County, then County may utilize the Office of t he County Counsel or employ separate outside counsel to represent or·
<br />defend the County, and I shall pay the reasonable attorneys' fees and costs of such counsel.
<br />I, further, certify under penalty of perjury that I am (check one):
<br />� legal property owner (owner includes partner, trustee, truster, or corporate officer) of the property(s) involved in this
<br />application, or
<br />D Legal agent (attach proof of the owner's consent to the application of the properties involved in this application) and.
<br />have been authorized to file on their behalf, and that the foregoing application statements are true and correct.
<br />Print Name: _;;;D;;...o=u..._g..__la=s"-'Rc..;;...;;;C=la=-y....,,to=n----__
<br />Print Name: ---·�------
<br />Print Name: -�---------
<br />Print Name: =-��--�-���
<br />Print Name: �------�---
<br />Signature: ��. -0. <" K � J _-::;-:--Date: 1 Jfltj .2.C>"Z.\
<br />Signature: ___ -_-_9,__ __ � ___ 1_ Date: ____ _
<br />Signature:Date:-�---
<br />Signature:Date: ____ _
<br />Signature:Date: --�--
<br />--me appllcannsammmnmfieSmc@on lWelftlpolltan "Afpoff ananassuffiaennnmrest mffie sul>Ject propertyloliliflffislippllcatloi'[Tnavereviewed the intended use aind approve the operation subject to approval of the design review committee.
<br />Prlnt Name: Russell Slark Slgnarure�.,lf!!ii
<br />Date: l;.. IA ( °?) 'to ?-1,1rport ctor
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