|
SITE ADDRESS: 28372 Mannola Ave. Escalon PERMtY#t
<br /> Plot Isten:
<br /> OIS CoordInate:Latitude: az.atzse ongltude: -�2o,ttaaas
<br /> 1,the QwjWjfWplicanlVUoensed Well Ulter/Pump Contmctor agrees to Indemnify,defend with counsel reasonably approved by County,and hold harmless
<br /> the County and de offtars,offtdals,emptoyaos,agents,board,,and commleelons(oolladively"County"}as fottawa,
<br /> x. Indemnity:
<br /> a, From and agatnat any and all clalms,demands,ad w%pro<eodinp,lewaulta,losses,damages,judgments and/or liabilities arising out
<br /> of,rotated to,or in ConneCUan With the apptieallon and appied for wait or pump or to attack,oat aslde,Void,or annul,In whole or In part,
<br /> approval or denial of the applied for permit by the County.and any anvironrnental review documents related to the gppl(ad for permit:
<br /> b, For Any and all costs and expenses incurred by the County on account of any Ciatm,except where such indemnffiaauon is prchiblled by
<br /> law,Including but not Iimitad to damages,casts,&Vansas,attomay's fees,or expert vAums oosta that may be asserted by any person
<br /> or entity,private aaorney general Not olelt'nW by or awarded to any party agatnat the County,and the County's OWN Inoumo In pmporing
<br /> an edminlrttativa record which we not paid by the petitioner,
<br /> c. Except as to the County s sole negligence w wiMl miscorAud,
<br /> 2, Deforw
<br /> P. The County may participate or dlroot thus"W of any Claim,The Countyu acWns in defense of any datm shall not retlova me of any
<br /> obilgation to IndemrRy,defend,and hold haffoleas the rtlly.
<br /> b, In the event of a disagreement hnhvaan County and me ragar&V deferute of arty Ctlm.the County ch14 have the authority to control
<br /> the Iltlgatlon and make tf l9atfan detisiona,Indudtng,but not limited to,the manner In Which the deform IQ oondwtd,
<br /> if County rosonably determines that having common co(meel presents ouch oounael with a conflict of Interest,or if I fait to promptly aasuune the defanaa of
<br /> any Cialm or to promptly employ 00tgtb41 mag000bty,eatisfaatory to the County,then County may Ut1lize the Office of the County cmrnaat or employ separate
<br /> outside counsel to represent or defend the County,rsd I shall pay the reasonable attameys'fees and costs of sut h kxxrr'rturl,
<br /> f HEREBY CERTIFY THAT i HAVE PRItPARED TH18 APPLICATION AND THAT THE WORK WILL BE DONS IN ACCORDANCC WITH SAN JOAQUIN
<br /> COUNTY OMINANCES,STATE LAWS,AND RULES AND REGULATIONS. I ALSO CERTIFY THAT MY REQUIRED LICENSE 19 Ct71 LINT ANI!
<br /> ACTIVE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE SOARD AND THAT I AM IN COMPLIANCE WITH ALL WORKERS
<br /> COMP12NSATION LAW .
<br /> ArroreR,~roxr�►En: and S m^ � I�w���S�
<br /> slow
<br /> Lie-"W WELL Dn1LLBRftMP oxrxnCrog: � Seam Roddy
<br /> Blcin: Rnrr: Hennings Qros.ladlffng Co_, Inc. by DAT9ddll„�2 X2024
<br /> AUTHORIZATION FOR OTWER THAN C-57 SIGNING PERMIT APPLICATION
<br /> I ,hereby authorize
<br /> (Wmc C-s� cc,uod Aatrd RtNddfltt rn; .. (11'{M NlnteOrAulhoriaDd Ascot}
<br /> to.sign this San,Joaquin County Well&Dorine POtmit Application on my behalf.I understand this authorization is valid for one year and
<br /> is 11rmiied to the work pian dated on the front gage of this application.
<br /> NMD 43-0 WELL DESTRUCTION PERMIT
<br /> i 1=21
<br />
|