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i SAN JOAQUIN <br />COU iNTY <br />-r--r,f: r+n.ec herr <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />BUSINESS LICENSE <br />FILE NUMBER 1106261 <br />FOR STAFF UV ON! <br />Response Due Date: <br />Business Information <br />A licant Information <br />Business (DBA) Name. <br />Name: <br />Mailing Address: IZo <br />Mallin Address:3— <br />Z <br />-C, <br />(a.21 l� - -- - <br />A. <br />Phone: 1c, 1_,2 9 y -J_,2 G S (� <br />- <br />Phone:Xon <br />Email: Dkv FMXpre-s-C.CCwN <br />Email: <br />r <br />Property Information <br />AssessorP-a�rcel Number Property Address <br />City <br />Cross Street <br />1422 9-7 <br />Business Details <br />Description of Business: <br />- --------- -��� � a K l /sit -- � Y <br />Type of Organization: ❑ Single Owner ❑ Partnership ration ❑ Other: <br />Does the business include the sale of firearms? ❑ Yes [�No <br />Number of Employees <br />Hours of Operation <br />Water Service <br />Sewer Service <br />— Full Ti _ PartTime <br />7"331 <br />Public Private (on-site) <br />Public Private (on-site) <br />El❑ <br />AUTHORIZATION SIGNATURES <br />I, the Owner/Applicant/Agent agrees to indemnify, defend (with counsel reasonably approved by County), and hold harmless the County and its officers, <br />officials, employees, agents, boards and commissions (collectively `County") as follows: <br />1. INDEMNITY: i <br />A From and against any and all dams, demands, actions, proceedings, lawsuits, losses. damages, judgments and/or liabilities arising out of, <br />related to, or in connection with the application and applied for project or to attack, set aside, void, or annul, in whole or in part, an approval of <br />the applied for project by the County, the adoption of environmental review documents related to the applied for project, and any related <br />development approvals or project conditions for the applied for project (hereinafter "Claim")' <br />B For any and all costs and expenses incurred by the County on account of any Claim, except where such indemnification is prohibited by law, <br />including but not limited to damages, costs, expenses, attomey's fees, or expert witness costs that may be asserted by any person or entity, <br />private attorney general fees claimed by or awarded to any party against the County, and the County's costs incurred in preparing an <br />administrative record which are not paid by the petitioner. <br />C. Except as to the County's sole negligence or willful misconduct. <br />2. DEFENSE: <br />A The County may participate or direct the defense of any Claim. The County's actions in defense of any claim shall not relieve me of any <br />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 have the authority to control the <br />litigation and make litigation decisions, including, but not limited to, the manner in which the defense is conducted. <br />C If I fail to promptly assume the defense of any Claim or to promptly employ counsel reasonably satisfactory to the County, then County may <br />utilize the Office of the County Counsel or employ separate outside counsel to represent or defend the County, and I shall pay the reasonable <br />attom 'fees anigis of such counsel. /_ /1-D <br />;�i; <br />Print Name: Signature: Date % I�%7 <br />FOR STAFF USE ONLY <br />General Plan Designation _j L <br />Zoning Designation: L _ �o�r Use Type. .i <br />Department <br />Approved <br />Denied <br />Signature <br />6ate <br />CDD. Planning Division <br />�j <br />�L <br />6 <br />Building Division <br />T <br />Fire District' — SviL <br />Environmental Health Department <br />Department of Public Works <br />MHCSD (if applicable) <br />License approved for <br />------ ----- <br />History <br />Final zed by Date <br />