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• SITE ADDRESS: 20287 E. Mariposa Rd. PERMIT:
<br /> Plot Plan:
<br /> GIS Coordinate:Latitude: '.7_Rf,928(1 Longitude: 2LOii.'i1R9
<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
<br /> out 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
<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,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 /> 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
<br /> separate outside counsel to represent or defend the County,and 1 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 /> JOAQUIN 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 BOARD AND THAT I AM IN COMPLIANCE WITH ALL
<br /> WORKERS COMPENSATION LAWS.
<br /> PROPS
<br /> SIGN: ppwff: r A z?ni Tc/�,a►,� 15-12
<br /> Luesseu�'ft:r.r.Dku.r.ekrnr�rryyNTRACIO(�RR: \� C Sean Roddy,.
<br /> SIGN: ',} ,U 7 `� PRINT; ,iennings Bros. Drilling Co. by pgTE March 27,2024
<br /> AUTHORIZATION FOR OTHER THAN C-57 SIGNING PERMIT APPLICATION
<br /> I, herebv authorize
<br /> \acne,f C.S-I_acr_ed AuthuruN Rryrrc.matrve —_ - N,n N,,n,c of.A,11--f Ap-t
<br /> to sign 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 /> FRfxM3.06 IN?5'202I I'agc?ur_' Wcll I rum Pmnn
<br />
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