|
SITE ADDRESS: 640 E. Eleventh St.. TraCV PERMIT#:
<br />Plot Plan:
<br />:
<br />I I ( 1
<br />I I I I I
<br />I I I I I II
<br />I I
<br />T
<br />'I 1 !I i I I I I II
<br />it I II I it
<br />Ili I it II I I I I I!I
<br />I I I I I I I t i l 1 i I Jill I I I! Ii
<br />I -
<br />li I
<br />GIS Coordinate: Latitude: 37 73898 Longitude: -121 411j?7
<br />I, the Owner/ApplicanULicensed 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 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 permit.
<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 LAW/ i
<br />PROPERTY OWNER: t..,.
<br />SIGN: PRI T:Charaniit Ghai DATE 08/23/92
<br />..L)..15�.
<br />.Ic o-asuo ��9il.l. DRn.l.rai/PUMP CONTRACTou;
<br />s Sean Roddy
<br />SIGN: A I -W Tf�}i BX,04-. � Yw ]b7PRINT: rltennings Bros. Drilling Co. by DATE Aug. 23, 2022
<br />AUTHORIZATION FOR OTHER THAN C-57 SIGNING PERMIT APPLICATION
<br />herebyauthorize
<br />tVaree ,H'l'_j7 L --d Autlw —d R. pm,,:,tal-j Wrml N:mw of Aulh,-nd A_emi
<br />to si,n 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.
<br />EHD 43-08 'HELL DESTRUCTION PERN4IT
<br />1'1/23/21
<br />
|