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SAN JOAQUIN COMMUNITY DEVELOr�MENT DEPARTMENT
<br /> - ADMINISTRATIVE/CONDITIONAL USE PERMIT
<br /> COUNTY - -
<br /> FILE NUMBER-
<br /> LEVINE ACT
<br /> Effective January 1,2023,California Political Reform Act of'1974. Government Cotler§84306,known I have read and understand
<br /> as the Levine Act,prohibits any San Joaquin County Boartl of Supervisor member from participating in that this application Is
<br /> any agenda item Involving a discretionary land use permit or other entitlements if the Board member .t t�sayrpwsions:
<br /> has received any poli[Ical contributions from the owner, applicant, or agent for the owner or applicant 4/(Y/�
<br /> totaling m ra then$250 In the 12 months before the decision(but not before January t,2023)and far Initial
<br /> the 12 months following the decision.Ther Ac[also prohibits an owner,applicant, or agan!for the owner
<br /> or applicant from making a contribution of more tM1an$250 fo a member of the Board of Supervisors
<br /> while[ha item is pending and for the 12 months following the data a(nal decision Is rentlaretl. Date
<br /> AUTHORIZATION SIGNATURES
<br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION
<br /> 1,the Owner/ApplicanVA9ant agrees to Intlemnify,defend(with counsel reasonably approved by County).and hold hanniass the County
<br /> and its officers, officials,employees,agents.boartls and commissions(collactivaly"County")es follows:
<br /> 1. INDEMNITY:
<br /> A. From and against any and all claims,demands,actions,procaatlinga, lawsuits, losses,damages,judgments end/or
<br /> Ilabilitias arising out of, relatatl to, or in connection with the application and appiiatl for project or to attack, sat aside,void,or ennui.In
<br /> whole or in pert.an approval of the applied for project by the County,iha adoption of environmental review documents ralatatl to the
<br /> applied for project, and any relatatl development approvals or project contlkiona for the applied for project(M1erainaRar"Claim");
<br /> B. For any end all cosffi and expenses incurratl by[ha County on account of any Claim,except where such intlamniicetion is
<br /> prohibited by law, including but not limited to tlamagas,costa,expenses,attorney's fees,o expert witness costs that may ba asserted
<br /> by any parson or entity,private attorney general fees claimed by or awarded to any party against the County,and the County's coats
<br /> nwrred in preparing en adminisfra[iva record wM1icM1 are no[paitl by the petitioner.
<br /> G. Except as to the County's sola negligence or willful miscontluct.
<br /> 2. DEFENSE:
<br /> A.Ther County may participate or direct the defense of any Claim.Ther County's actions in tlefansa of any claim shall not
<br /> relieve me of any obligation to Indemnify,tlefantl,and hold harmless the County.
<br /> B.In the avant of a disagreement between County and ma regartlin9 defense of any Claim,the County shall haus the
<br /> authority to control the litigation and make litigation decisions, including. but not limited to,the manner in which the tlefense is
<br /> ontlucffitl.
<br /> 0.If the County reasonably detanninas[hat having common counsel presents such counsel with a conflict of interest,or if I
<br /> fail to promptly assume the tlafansa of any Claim or to promptly employ counsel reasonably satisfactory to the County,than County may
<br /> uFliza the Office of the County Counsel o employ separate ouffiida counsel to represent or defend the County,antl 1 shall pay[ha
<br /> reasonable aKornays'fees and cosffi of such counsel.
<br /> 1,further,certify antler penalty of perjury that I am(check Dna):
<br /> � Lagel property own r(owner Inclutlas partnaq trustee.trustor,or corporate officer)of the property(s)involved in tMs application,or
<br /> Q Legal agent(attach proof oP Ura owners consent to the application of the properties Involved In this application)and have bean
<br /> authortzetl to fila on chair behalf,antl that the foregoing application statements are true antl correct.
<br /> Pnn<Nama: Jack P �BLiddo sisnamre: Data: June 6tM1, 2Qj
<br /> Print Name: Signet Data:
<br /> Print Nama: Signature: Data;
<br /> Prins Nama: Signature: Data:
<br /> PrinF Nama: Signature: Data:
<br /> Page 6 of 6
<br /> 03/28/2023
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