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SAN a O A Q U I N COMMUNITY DEVEiLOPMIENT DEPARTMENT
<br /> _C0I.J Nl'Y--__- SITE APPROVALiUSE PERMIT
<br /> G -eeitness rgrata s /rt re.
<br /> FILE NUMBER:
<br /> ,AoUTHC9RIZATION SIGNATURES
<br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATiON
<br /> I, 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 /> follows:
<br /> 1. iNpEMNITY:
<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"Claim");
<br /> 6. 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.
<br /> C. Except as to the County's sole negligence or willful misconduct.
<br /> 2, DEPEN$E:
<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 /> S. In the event of a 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.
<br /> C. If the County reasonably determines that having common counsel presents such counsel with a conflict of
<br /> interest,or If I fall 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 represent or
<br /> defend the County, and I shall pay the reasonable attorneys'fees and costs of such counsel.
<br /> —I–f�irther,–certify-ursd e alty—of perjury that-i am(dheck one):
<br /> @'Legal property owner(owner includes partner, trustee,trustor,or corporate officer)of the property(s)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:xa�tn\ \ 1- ACI"'&a C (\'tignature: `� �- .. 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 /> 08/1312021
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