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SITE ADDRESS: 980 Warren Rd., Ripon PERMIT #:
<br />Plot Plan:
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<br />GIS Coordinate: Latitude: 37 74966
<br />I, the Owner/ApplicanULicensed Well DrillerlPump Contractor agrees to indemnify, defend with counsel reasonably approved by County, and hold harmless
<br />the County and its officers, officials, employees, agents, boards, and commissions (collectively 'County") as follows:
<br />1. Indemnity:
<br />a. From and against any and all claims, demands, actions, proceedings, lawsuits, losses, damages, judgments and/or liabilities arising out
<br />of, related to, or in connection with the application and applied for well or pump or to attack, set aside, void, or annul, in whole or in part,
<br />approval or denial of the applied for permit by the County, and any environmental review documents related to the applied for pen -nit;
<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
<br />law, including but not limited to damages, costs, expenses, attorney's fees, or expert witness costs that may be asserted by any person
<br />or entity, private attorney general fees claimed by or awarded to any party against the County, and the County's costs incurred in preparing
<br />an 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
<br />the litigation and make litigation decisions, including, but not limited to, the manner in which the defense is conducted.
<br />If 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
<br />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
<br />outside counsel to represent or defend the County, and I shall pay the reasonable attorneys' fees and costs of such counsel.
<br />I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN JOAQUIN
<br />COUNTY ORDINANCES, STATE LAWS, AND RULES AND REGULATIONS. I ALSO CERTIFY THAT MY REQUIRED LICENSE IS CURRENT AND
<br />ACTIVE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT I AM IN COMPLIANCE WITH ALL WORKERS
<br />COMPENSATION LAWS.
<br />PROPERTY OWNER:
<br />SIGN: PRINT: K { r k C L 0,` Q,` P - DATE 01 19
<br />l.lcr:�sr:u�1'ci.l.i)un.�.la</ oxc e�,/
<br />SIGN:14AM21S .lft- �-�'�- oho Q '� � Y� PRINT:Hennings Bros. by Sean Roddy DATE May 17, 2822
<br />AUTHORIZATION FOR OTHER THAN C-57 SIGNING PERMIT APPLICATION
<br />I. . hercb_v authorize
<br />1 Xam: ofC-?7 Liccm:d ,\udwrinl Rq+nwolmieci O'rim N.—of Amh.,wd AFcml
<br />to sign this San Joaquin County Well & Boring Permit Application on my behalf. 1 understand this authorization is valid for one year and
<br />is limited to the work plan dated on the front page of this application.
<br />EHD 43-08 WELL DESTRUCTION PERMIT
<br />11123/21
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