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: i = QACOMMUNITY DEVELOPMENT DEPARTMENT
<br /> -----COU -- SITE>APPRt)VALIUSE PERMIT
<br /> ,r.r" Greatness f -owes h�i -e:
<br /> FILE NUMBER.
<br /> AUTH+0R1 ►TION SIGNATURES :
<br /> ONLY THE OWNER JOF THE.PROPERTY OR.AN AUTHORIZED.AGENT MAY FILE AN APPLICATION.
<br /> 1,-the Owner/Applicant/Agent 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"County')as
<br /> foilaa�s:
<br /> i. '11STi71cfilitSti3Y:
<br /> A.from and against any and aii claims,demands,actions,proceedings,lawsuits,fosses, 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 orin 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"Claim");
<br /> B. For any andall 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 /> C. Except as to the County's sole negligence or willful misconduct.
<br /> Z. DEFENSE:
<br /> A.The County may participate or direct the defense of any Claim. The.County's actions in defense of any.
<br /> claim shall not relieve me of any 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
<br /> have the authority to control thelit'igatior and make litigation decisions, including,,but not limited to,the manner in which
<br /> the defense is conducted.
<br /> 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 the County Counsel or-employ separate outside-counsel to representor
<br /> defend the County,and I shall pay the reasonable attorneys'fees and costs of such counsel.
<br /> 1,further,certify under penalty.of perjury that I am(check one):
<br /> 0 Legal property owner(owner includes partner, trustee,trustor,or corporate officer)of the property(sl involved in this
<br /> application,or
<br /> [] 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: Lignature: Date:
<br /> Print Name: Signature: Date:
<br /> Print Name: Signature: Date:
<br /> Print Name: Signature: Date:
<br /> Print Name: Signature: Date:
<br /> Page 6 of 6
<br /> 08113!202'
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