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COMMUNITY ® EVES `NPMENT DEPARTMENT � a Sm-A zJ0 QUItvv iSITE APPROVAL/ USE PERMIT C O _ U .N T: '� Gt- FILE NUMBER : AUTHORIZATIOt�t SIGNRE - - _ -0NLY THE -OWNER: OF` THE" PROPERTY OR AN AUTHORIZED , AGE NT MAY FILE AN APP. LICAT1t3iV 1 , the Owner/Applicant/Agent agrees to indemnify , defend (with : counsel. reasonably , approved by Count y) ; and Hold harmless the County and its officers , officials, employees , agents ,. boards and commissions. (collectively `° County" ) as follows : w INDEMNITY : . . A. From and . against any and all claims , ' demands , actions , = proceedings , lawsuits losses , damages , = judgments and /or liabilities arising out of; 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 the applied for project by the County , the of environmental review documents related to the. applied for project ; . and any related development approvals or project conditions. for the applied for project ( hereinafter " Claim " ) . B . : For any and all costs arid - expenses. incurred by the County on account . of. any Claim ; except where such indemnification is prohibited bylaw , including but not limited fo damages, -costs ; expenses , attorney's fees ; or eXpert witness costs that may be asserted by many person or entity; private attorney . general fees claimed by or awarded to -any party against the County , and the County's costs incurred . in preparing an administrative : record which are not paid by the petitioner. C . Except as to the County's sole negligence or willful misconduct . 2 . DEFENSE: A. The County may participateor direct the defense of . any Claim :, The County' s actions in defense of any - claim shall not relieve me of any obligation to indemnify , defend , and hold harmless the :County. B . In . the event of a . disa_greement between County and me regarding defense of any Claim, the County shall . have the authority to. . control the litigation .and make litigation decisions , including , but not limited - to , the manner in which the defense is conducted : C : 4 if the - County: reasonably determines . that having common counsel presents such counsel with a conflict of interest , or if I fail to promptly :assume the defense of : any Claim or to promptly: employ counsel reasonably satisfactory to the County ; then County+ . may utilize. the Office: of the County Counsel or employ separate outside counsel to represent or defend the County , wandj shall pay the reasonable attorneys '' fees and4 costs of such counsel : I , further, certify under penalty of perjury that I am (check one) : ❑ Legal property owner (owner includes partner , trustee , trustor, or corporate officer) of the property ( s ) involved in this application , or ❑ Legal agent ( attach proof of the owner' s consent to the application of the properties involved in this application ) and have been authorized to file on their behalf, and that the foregoing application statements are true and correct . Print Name : �� o�� / jl�ikLSignature : Date : i Print Name : Signature : Date : i Print Name : Signature : Date : Print Name : Signature : Date : Print Name : Signature : Date : Page 6 of 6 08/13/2021