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<br /> SITE fWRRE$S: � ��1 L =�(1� I a) PERMIT
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<br /> ;} 7N Kenneti.-.k Road y a a
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<br /> L the OwnerlApplr�nt%Licensed Well Driller/Pump Contractor agrees to indemnify,defend with counsel reasonably approved by County,and hold harmless
<br /> ,he County and its officers,officials.Employees,agents,boards,and commissions(collectively"County")as follows:
<br /> Indemnrtv:
<br /> a. From and against any and all claims,demands,actions, proceedings,lawsuits,losses,damages,judgments and/or liabilities arising
<br /> Y out o`•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
<br /> part.approval or denial of the applied for permit by the County,and any environmental review documents related to the applied for
<br /> Ie mr.
<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 /> f 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 Claret 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 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
<br /> 10AQUIN 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 130ARD AND THAT I AM IN COMPLIANCE WITH ALL
<br /> WORKERS COMPENSATION LAWS.
<br /> PI;OPEP Tl OWNED(SIGNA.TURE IS REQUIRED FOR WATER EX TRACTION WELL ON PRIVATE PROPERTY):
<br /> PRINT:-Angel ica Adarie DATE 10/24/2022
<br /> L.Irl�\I U\1 i.l t nlcll�IJt/I'I I O.'.1 K1t T I1K:
<br /> 51G N: v _ PRINT:_f�l.-1)11 �.JC.1 1 DATE L 2_
<br /> A111 110RILATION 1`0k OTI il:k"1'I IAN C-S7 SIGNING PERMIT APPLICATION
<br /> IChy all thuriir
<br /> t , .I,n tile. ,.w I, ,,._font 1 utuuy 1rr'rll rF limin^ Pertnit Applir:uiml on Ink.behalf.I un(lrraand this authorization is void For one year and
<br /> limi(c'd In Illi v rill.plan doted un fhc trout paee of Oik,ij)plication.
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