My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
WP0043032
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
M
>
MACKVILLE
>
27551
>
4200/4300 - Liquid Waste/Water Well Permits
>
WP0043032
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
10/11/2022 10:09:12 AM
Creation date
10/11/2022 9:40:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043032
PE
4369
STREET_NUMBER
27551
Direction
N
STREET_NAME
MACKVILLE
STREET_TYPE
RD
City
CLEMENTS
Zip
95227-
APN
00911030
ENTERED_DATE
3/3/2022 12:00:00 AM
SITE_LOCATION
27551 N MACKVILLE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2022
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
12
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
r, I p' <br />SITE ADDRESS: 2 1'j 95 I N. 1' 1 rn a W H W � . PERMIT #: <br />Plot Plan: <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 connection with the application and applied for wed 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 />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 <br />by law, including but not limited to damages, costs, expenses, attorneys 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 casts incurred <br />in preparing an administrative record which are not paid by the petitioner. <br />c. Except as to the County's sole negligence or wilful 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 mel 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 <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 I HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN <br />JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULESAND-REGULATIONS. I ALSO CERTIFY THAT MY REQUIRED LICENSE IS <br />CURRENT AND WITH THE CALIFORNIA CONTRA STATE LICENSE BOARD AND THAT I AM IN COMPLIANCE WITH ALL <br />WORKERS COM TION LAWS, <br />PROPERTY <br />Ste• Olvt PRINT: 12 0, DATE _ <br />LlcENsEl) WELL RACrOR: <br />Ste• PRINT: 9 ' lUl�r I Y DATE <br />AUTHORIZATION FOR OTHER THAN C-57 SIGNING PERMIT APPLICATION <br />L , hereby authorize <br />Na ofC-57 Lreawd AWJxw®d RqrmcW*ivc Prmr Na of Awhonwd Agag <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 />EHDO43-06 10252021 Par 2 of 2 WA) Ptunp Penni <br />
The URL can be used to link to this page
Your browser does not support the video tag.