Laserfiche WebLink
. t <br /> SITE ADDRESS: PERW 0: <br /> Viol Waw: r <br /> -7-71-17 <br /> - <br /> _ -A. <br /> I i <br /> rl <br /> TT <br /> + - <br /> s . <br /> I i <br /> - <br /> _.. <br /> 1 I <br /> GIS CoornYnate Latitude <br /> I."Owner.'Apolicantilkensed Well DrAer+Pump Contractor agrees to indemnify.defend with counsel reasonably approved by County and hold harmless <br /> Mie County and All OfpOMs dHlnals,employees.agents.boards,and oa rrntss ons(copecbvefy-CotrNy')as follows <br /> 1 Indemnity. <br /> a From and agaatst any and all Uams.demands.actwwa.proLeedostp.lawsuts.khssia. dannagos.pAgments andfun 6abitties an" <br /> out of related to.or in connection with the appirabon and applied for well or pump or to ar=kset asv%,vn4 or anrxA.in w0+nke nr.n <br /> Pon.approval or dernat of the apoled for perma b1+line County,aria any erlvaonmcM review,documents+elated N the applied for <br /> permit: <br /> b Fa any and dt Costs and agwr um rn,nud by tna County on accawa of any Claus.exceyt where such mtlemnifwAt�on a proh*ded <br /> by law.including but not IetMed W damegea,xats,expenses.attorney's top.or expert witness cost*Nat may be asserted by any <br /> pe son or anWV.private attorney general fees clamed by Or awarded to any party against Mro County.and the Countys costs incurred <br /> A pfeparrng an admvwgraWe record%tach aro not pad by lite pabboner. <br /> C Except as to <br /> the County a sod negltgarw a or wj"A ro sco'KW <br /> I Defense <br /> a. The County may participate or drat:ttna defense of any Clam The Coumt/s actions to defense of any darn stop not repave mo of any <br /> obhgabon to ndenady.defend.and hold ttannless Ne County <br /> b. In Vte event d a daagreament betwsorh County and me regarding defense d any Clem,the County ship have the aumury to coram <br /> Ne*%non and make MVabon deceions,atckxlv+g,but not k mUA to,the manner in which the defense is conducted <br /> If Corny reasonably determines that hawg common counsel presents such counsel we a conflict of in emi,or 0 1 fad to promptly ass:rne the cleanse of <br /> arty Clams or to promptly,employ aiur ef reasonably sat+stactory lel lite County.uteri County may utAhze the Otlhce of the County Counsel or employ <br /> separate ovWft counsel to represent or defend the County.and 1 shell pay the reasonable attorneys fees and costs of such courael <br /> 1 HERESY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DOME W ACCORDANCE WITH SAN <br /> JOAOUIN COUNTY ORDINANCES, STATE LAWS, AND MAJES AND REGULATIONS. 1 ALSO CERTIFY THAT MY REQUIRED LICENSE IS <br /> CURRENT AND ACTIVE VATH THE CAUPORIMA CONTRACTORS STATE LICENSE BOARD AND THAT 1 AM MI COMPUAMCE WITH ALL <br /> WORKERS COMPENSATION LANES <br /> fkorl M Z..16 �Cr.WAnN ypw•�•�+*AW mil'io Razo Dara 10-3-22 <br /> t.Ici�lrb�N.—r�k� 1�Y.R�I�h,,�M►C'P�t1t+c7xwc �1 <br /> S.C.: �HCU:Wit ^ Pkewr T/1f r htcl r f , Sc n DATE `l <br /> AUTHORIZATION FOR OTHER THAN C-57 SIGNING PERMIT APPLICATION <br /> hereby authowe <br /> �..,...r< .•t....«�tee.,...-n NssK.M.•.r,. n..'.A..0 <br /> to<Ign this San Joaquin County WC11&Boring Pet'mit Application oin my behalf I under-stand this auth xvation is 6alid ftx onC year atut <br /> I%lirnitcd to the wurk plan detect on the f om pagC Of the..dpPlicauon <br /> WIT-2a.1-1 ry- w.i r.rn.r.x <br /> Thank you , <br /> Emilio <br />