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SrTF At)tTRESS: 1 o,1i Cin i 1_I (n C)5PERMIT#:----
<br /> FTTI I I I I
<br /> F dot Pl+n.
<br /> XN Kennefick RoadFIR
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<br /> I
<br /> --; _-- -
<br /> � _ Septic and
<br /> leach lines + t
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<br /> Well
<br /> 41 P
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<br /> � I r� � •IF: t .�%.I'I
<br /> ;�ate Lantude_ / Longitude: - /
<br /> theLixnsed Well Driller/Pump Contractor agrees to indemnify,defend with counsel reasonably approved by County,and hold harmless
<br /> j the Coum, i�,-.<officers.officials,employees,agents,boards,and commissions(collectively"Couny)as follows:
<br /> j a f rom and against any and all claims,demands,actions,proceedings,lawsuits,losses,damages,judgments and/or liabilities arising
<br /> o:n at,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 /> k pe-ml-.
<br /> I 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 preparino an administrative record which are not paid by the petitioner.
<br /> k c. Except as to the County's sole negligence or willful misconduct.
<br /> 2. Defense
<br /> a. The Co:utty 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 /> 4 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 /> i 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 it 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 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 /> JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES AND REGULATIONS. 1 ALSO CERTIFY THAT MY REQUIRED LICENSE IS
<br /> CURRENT AND ACTIVE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT 1 AM IN COMPLIANCE WITH ALL
<br /> WORKERS COMPENSATION LAWS.
<br /> PROPERTY OWNER(SIGNATURE IS REQUIRED FOR WATER EXTRACTION WELL ON PRIVATE PROPERTY):
<br /> SIGN: - _ PRINT: Angel i ca Adame DATE 10/24/2022
<br /> LvIGN:e"i t,\U.LI Ru I.rJI
<br /> �iI r't,nrRnl'tON: ��QQ Tom+ �p y�
<br /> I
<br /> _ PRINT: 1��'' �J�-�Jl.1 L -_. DATE , 2,2-
<br /> At I
<br /> ,ZAU 11101WATION FOR OTHER TIIAN C-57 SIGNING PERMIT APPLICATION
<br /> I. - _----•hereby:uuhnrii�•
<br /> o .I rI this. `•.n 1, ,,yuw t',nuup Wcll Burin,'1'crNli(Appliratjun uu u{y txhalf.I understand this authorization is valid for one year and
<br /> 1I Iniled to 111r \'.in 1.Idau d.urd uu the Irrmt page of (his application.
<br />
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