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SAN �OAQUIN COMMUNITY DEVELOPMENT DEPARTMENT
<br /> - r. oul�lry ADMINISTRATIVE/CONDITIONAL USE PERMIT
<br /> FILE NUMBER:
<br /> LEVINE ACT
<br /> Effective January 1, 2023, California Political Rafonn Act of 1904, Govarnmenf Cotler§84308, known I have read and understand
<br /> as the Levine Ac[, prohibits any San Joaquin County Board of Supervisor member from participating in that this application is
<br /> any agenda item mvo Ning a discra[ionary lantl use permit or Dinar an[i[laman[s if[ha Board member subject[o ase provisions:
<br /> has received any political contnbu[ions from fha ownaq applicant,or a9anf for the owner or applicant
<br /> totaling more than$250 in iha 12 mon[ha before fha daciaion(but not before January t,2023)and for Initial
<br /> the 12 months following the decision.Ther Ac[also prohibits an ownaq applicant,or agent for the owner
<br /> applicant from making a contribution of mora than$250 to a member of the Board of Supervisors "12/4/23
<br /> while the item is pantling antl for fha 12 months following the tlata a Flnal decision is rantlerad. Date
<br /> AUTHORIZATION SIGNATURES
<br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION
<br /> I,the Owner/Applicant/Agant agrees[o intlamnify,tlafand(with counsel ra nobly approvatl by County), and holtl harmless the County
<br /> end its officers, officials.employees,agents,boartls antl commissions(collectively"County")as follows:
<br /> 1. INDEMNITY:
<br /> A-From antl against any antl all claims,tlamands,actions,proceedings, lawsuits, Iwsas,damages,judgments antl/or
<br /> Ilabilitles arising out of, relatatl to,o action with the application antl applied for project or to attack,sat aside,void,or annul, in
<br /> whole or in part,a approval of the applied for project by fha County,the adoption of environmental re w documents related to the
<br /> applied for pmjec4 and any relatetl tlavalopman[approvals or project contlitions for[ha appliatl for project(hereinafter"Claim');
<br /> B. For any and all costs and expanses incurretl by the County on a unt of any Claim,a capt where such indemnification is
<br /> prohibited by law, including but not limitatl to tlama9as,costs,expanses,attorney's fees,o expert witness costs that may be asserted
<br /> by any person or entity, private attorney general fees claimatl by or awardatl to any party against[ha County,antl the County's costs
<br /> ncurretl In prepedng a administraflva racortl which era not paltl by the petitioner.
<br /> C. Except as to the County's sole negll9anca or willful miscontluct.
<br /> 2. DEFENSE:
<br /> A. The County may participate or direct the tlafansa of any Claim.Ther County a acfiona in tlafansa of any claim shall not
<br /> relieve ma of any obligation to mdem mry, tlafend, ane ndtl harmless ma copn[y.
<br /> B. In the event of a disagreement between County and m ragartling tlafansa of any Claim,[ha County shall nava the
<br /> authority to control the litigation and make Iltiga[Ion decisions.inclutlin9.but not limited[o,fha manner In which the tlafansa is
<br /> ondpptea.
<br /> C. If the County re onably determines that having c n counsel presents such c sal with a onflict of interest,or if I
<br /> fail to promptly assume the defense of any Claim or[o promptly employ counsel ra nobly satisfactory to the County,than County may
<br /> utilize the Office of the County Counsel or employ separate oufaitla counsel[o represent or tlafantl[ha County,antl I shall pay the
<br /> reasonable attorneys'fees and costs of such counsel.
<br /> I,furthaq certify untler penalty of perjury[ha[I am(check Dna):
<br /> � Legal property owner(owner inclutles partner,trustee,trustor,or corporate officer)of the proparty(s)involyatl in this application,or
<br /> © Legal agent(attach proof of the owner's consent to the application of the properties involved in this application)antl nava bean
<br /> authorized to Flle on their behalf,antl iha[the foregoing application atataman[s are true antl correct.
<br /> Prin[Nama: Stephanie Loucas signature: Data: 'I?✓4/23
<br /> Print Neme: Signature: Data:
<br /> Print Nama: Signature: Date:
<br /> Print Nama: Signature: Date:
<br /> Print Name: Signature: Date:
<br /> Pag¢6 of 6
<br /> pa/zanoza
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