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C1R,� GEC(LlNTS'C2eO o iaaargcea4gpra&raraa+rrlanaa <br />Page 4 arg <br />A reap and legal doscriplir n has boon: <br />❑ f oelificd by the Counl7 Survoyror and is attached to this application. <br />U SuLvTfltted for review to the County Surveyor, <br />❑ tither (please extrlabi) <br />N/A. 7hc City is pr"ozaing a small inland annexation requcat. <br />Orange County LAFCO requires applicants to report all expenditures for political pwposos <br />raalatod to an applic cation and proceedings to he reported to lho Commission's Executive C7rt c>rar <br />in compliance, with Government. Codo Sections 56a700.1 and 57009. The follovAng is attached <br />to this application fans: <br />] I Disclosure Form (please complete la4EOC} &sc%sure of Patifrcat <br />Expon6t4rrot, A darhrri&nt 3); copy of Fi anOal reports and disclosures submitted to <br />FPPC (ploa.so Mlw-,h) <br />Please check pare if y6u have no related financial reports or disclosures, <br />LAFCO policy requires that all applicants sign an indemnification agreement (see Attachmort 1J <br />which indemnities LAFCO employees, agents and attorneys. In the event of litigation is filed <br />cone rninag that arprprovol cf an aapplicealion.. <br />The fetiowing is Included with this application form: <br />❑ Signed lndemnificalIon AgroernQrAr <br />ElLiNG UES., <br />,Applicaarats are required to pay fees in auvaardance n'rtlr OC LAFCO's adopted foe sehoc+"ulo (sea <br />Attachment 4) to corer tits atlrnirtastratn+e and slaaiff costs requeed to evaaWle, proposals for <br />hearinil. Checks must taa rnaddo payable to: 'Orango C'oority LAMO'; <br />The following is included with this application form., <br />F1 Check to Filing FC06 <br />❑ Other (explain why Filing Foes not inciu(lwf)! <br />As the Countya island is less than 150 acres in size, the OC LAFCO Commission will vfaive <br />the application freq. <br />7i'hi ffijvw eeSa7G:jCiuitdiaAf, of@1 JSinrlavptr4'Orf9N wo'k4'!ide, 14C(' fAwle,i,'Reikk ktivr& Aa'1f"olvj-'amm <br />Resolution No. 2019-077 <br />Page 9 of 14 <br />