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SANs�OADUIN COMMUNITY DEVELOPMENT DEPARTMENT
<br /> c o(�nlTv ADMINISTRATIVE/CONDITIONAL USE PERMIT
<br /> FILE NUMBER:
<br /> LEVINE ACT
<br /> Effective January 1.2023. California Political Reform Act of 1974,Government Cotler§84308,known I nava read ane understand
<br /> as the Lavine Act,prohibits any Sen Joaquin County Bpar'tl of Supervisor member Trom participating in that this application Is
<br /> any agenda item Involving a discretionary land use permit or other entitlemanm if the Boartl member subject to these provisions:
<br /> hes recefvetl any political contributions from the owner, applicant,o agent for the owner or applicant 'y1Z.A
<br /> totaling mora than$250 in the 12 months before the decision(but not before January 1,2023)and for Initial
<br /> Me 12 months following the daciaion. Ther Act also prohibits an owner,applicant,or agent for the owner
<br /> applicant from making a contribution of mora than$250 to a member of the Board of Supervisors 1/24/24
<br /> while the item is pentlin9 antl for the 12 months following the tlate a final decision is andaratl. 0 re
<br /> AUTHORIZATION SIGNATURES
<br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION
<br /> I,the Owner/ApplicanVAgent agrees to indemnify,tlemntl(with counsel reasonably approvetl by County), antl holtl harmless the County
<br /> antl Its officers, officials,employees,agents,boards end commissions(collectively"County")as Iollows:
<br /> 1. INDEMNITY:
<br /> A. From and against any and all claims,demands,actions,proceedings,lawsuits, losses,damages,jutlpments end/or
<br /> Iiabllltles arisin0 out of, related to,or in connection with the application end applied'for project or to attack,sat aside,void,or annul, in
<br /> whole or in part,en approval of the applied for project by the County,the atloption of environmental review tlocumants relatetl to the
<br /> applied for project, and any related tlavalopment approvals or project conditioner for the applied for project(hereinafter"Claim");
<br /> B. For any and all costa and expanses incurred by the County on account of any Claim,a capt where such intlamniflcation is
<br /> prohibited by law, including but not limited to damages,costs,expanses,attorney's fees,o expert witness costs that may ba asserted
<br /> by any person or entity, private attorney general mea claimed by or awarded m any party a9ainat the County,and the County's costs
<br /> ncurred in preparing an atlminiatre[iva record which a not paid by the petitioner.
<br /> G.Except as fo the County's sole nagli9anca or willful mlacontluct.
<br /> 2. DEFENSE:
<br /> A.The County may participate or direct Tha damnsa of any Claim.The County's actions in defense of any claim shall not
<br /> relieve ma of any obligation[o indemnify,tlamntl,and hold hannlesa the County.
<br /> B.In the event of a disagreement between County and ma regarding damnse of any Claim.the County shall have the
<br /> authority to control the litigation and make litigation tleclsions,Inclutling,but not limited m,iha manner in which Me tlefense is
<br /> ontludatl.
<br /> G. If the County reasonably tlaterminas that having common counsel presents such counsel with a conflict of Interest.or if I
<br /> fall to promptly assume the defense of any Claim or to promptly employ counsel reasonably satisfactory to iha County.khan County may
<br /> utilize the Offloe of the County Counsel or employ separate outsitla counsel to represent or defend the County,and 1 shall pay the
<br /> reasonable attorneys'fees end costs oP such counsel.
<br /> i,further,certify untlar penalty of perjury that 1 am(check one):
<br /> Q Legal property owner(owner Includes pertneq[tastes,trustor,or corporate officer)of the proparty(s)involved in this application,or
<br /> ® Legal agent(attach proof of the ownaYs consent to the application of the properties involved in this application)end have bean
<br /> au[hodzetl to fila on their behalf,end the[the foregoing application statements era true and correct.
<br /> Print Name: Michael Arnoltl signature: Dam: '1/24/24
<br /> Prins Nama: Signature: Data:
<br /> Print Nama: Signature: Data:
<br /> Print Nama: Signafura: Deter:
<br /> Print Name: Signature: Data:
<br /> Pages 6 of 6
<br /> 03/28/2023
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