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SITE ADDRESS: '17-100 !N. Bethany Rd., hIountain House PERMIT #:
<br />I, the Owner/Applicant/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 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 attomeys' 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 AN THAT I AM IN COMPLIANCE WITH ALL WORKERS
<br />COMPENSATION LAWS. Q �I°
<br />PROPERTY 0 R' r,
<br />SIGN: PRINT: A"�rU� 5+�� DATE
<br />I,ICI•:k�S]L:n 1�'F:LL DRILLER tl' (:U\'r R:�CI'(11.: ^ n L
<br />CI SLX�1wb�7 PRINT.
<br />L.-nnings Bros key Senn I orldy DATE I':'ici% ?i1 2f�77
<br />SIGN: �tsir�iY�tt1A�,>r1�J�,ed-.D.n>< =
<br />AUTHORILA11ON FOR OTHER THAN C-57 SIGNING PERIYIIT APPLICATION
<br />hereby auttttirizc _
<br />(Knnr oW-57 I ic—1 Autl•;nvci Rcprt- cn�a�,, a it Nary o AW), --i -i AgcaU
<br />to sign this San Joaquin County 11%ell &. Boring Permit Application un my behalf. I understand this authorization is valid for one vem- and
<br />is limited to the work plan datcd on the front page of this application.
<br />EIID •13.08 WELL DESTRUCTION PERMIT
<br />11t23121
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<br />I, the Owner/Applicant/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 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 attomeys' 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 AN THAT I AM IN COMPLIANCE WITH ALL WORKERS
<br />COMPENSATION LAWS. Q �I°
<br />PROPERTY 0 R' r,
<br />SIGN: PRINT: A"�rU� 5+�� DATE
<br />I,ICI•:k�S]L:n 1�'F:LL DRILLER tl' (:U\'r R:�CI'(11.: ^ n L
<br />CI SLX�1wb�7 PRINT.
<br />L.-nnings Bros key Senn I orldy DATE I':'ici% ?i1 2f�77
<br />SIGN: �tsir�iY�tt1A�,>r1�J�,ed-.D.n>< =
<br />AUTHORILA11ON FOR OTHER THAN C-57 SIGNING PERIYIIT APPLICATION
<br />hereby auttttirizc _
<br />(Knnr oW-57 I ic—1 Autl•;nvci Rcprt- cn�a�,, a it Nary o AW), --i -i AgcaU
<br />to sign this San Joaquin County 11%ell &. Boring Permit Application un my behalf. I understand this authorization is valid for one vem- and
<br />is limited to the work plan datcd on the front page of this application.
<br />EIID •13.08 WELL DESTRUCTION PERMIT
<br />11t23121
<br />
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