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jeAln:.3v -� "Y• PERMIT
<br />1, the Owner/Appiicant/Licensed Well Driller/Pump 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
<br />out of, related to, or in contraction with the application and applied for well or pump or to attacK set aside, void, or annul, in whole or in
<br />part, approval or denial of the applied for permit by the County, and any environmental review documents related to the applied for
<br />permR:
<br />b. For any and all costs and expenses incurred by the County on account of any Claim, except where such indemnification is prohibited
<br />by law, including but not limited to damages, costs, expenses, attorney's fees, or expert witness costs that may be asserted by any
<br />person or entity, private attorney general fees claimed by or awarded to any party against the County, and the County's costs incurred
<br />in preparing an administrative record which are not paid by the petitioner.
<br />c. Except as to the County's sate 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 />oNigation 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 pmsents 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
<br />separate outside counsel to represent or defend the County, and I shall pay the reasonable attomeys' fees and costs of such counsel.
<br />1 HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN
<br />JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES AND REGULATIONS. I ALSO CERTIFY THAT MY REQUIRED LICENSE IS
<br />CURRENT AND ACTIVE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT 1 AM IN COMPLIANCE WITH ALL
<br />WORKERS COMPENSATION LAWS.
<br />PROPERT�YC SER: Q� /' /� p,.�� 'l
<br />SIGN: E�//,i PRU,T AIVIc L 6AU1.4 r"i r"��OIJ DATE 2l -'I
<br />LICENsSin^W' LDRILLFWPUXIPCONTRACrOR:
<br />SIGN:,ll�nuir PwNr It C- R9f r'l Sort DATE 4 3 aR
<br />AUTHORIZATION FOR OTHER THAN C-57 SIIG�4NG APPLIC
<br />I, Dr9-.vl r -L f�I.�}if-Cl/t 1 ^� , hereby authorize _ = I�
<br />NrworC-52 Um"d Ard ued Rep—tii.e Prim Name.fA d—imd Aged
<br />to sign this San Joaquin County Well & Boring Permit Application on my behalf. I understand this authorization is valid for one year and
<br />is limited to the work plan dated on the front page of this application.
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