|
SITE AoaREss: PERMIT
<br /> Plot Mon.-
<br /> 4
<br /> 1 T,
<br /> 7
<br /> GtS
<br /> Cw,*r%we Lmu&.
<br /> D'WYPUfnp C44AWtOf&Wtft to dIdUmINN�,defwtd with coirtse!reeseTustity approved by Cwp-�f,and nolohemr4ew
<br /> rh
<br /> titer C—u-niv.-no Is ofTcerg,c0ciats,8MPkyt*M Ggerlts.boarda. ant)ecnnitwom(cce-ac1rwe4y'Co%.nty')as f9ikr*-4-
<br /> Frtorn and a7ainst any and at: cia;rrm. dernams, acuons, rx0coadinp, tavAur's. lossas Car-.ages 'LfdqTri-0r4S ar-.Wl Or irs'Xig
<br /> :;,Ll Of.rOtELtOd to,or in conr*cunn*ith 0*app4cnton and apOiec for vw"U or pump or to attack.sat 3540e, void of annul. .r*11 Vote of In
<br /> ;;,all, epwarij w deriai d Iha app;Iac for parntt by *.,m Courry an4r .11y rw.1,e* docurriff-Ls rv,.KW, � to no appl:ed to,
<br /> Few:
<br /> F-;,, my and ajt cczis ard eAparmes alclwred by ze C-ounty c..accowal of any Gtamb exrjarA#&'efe 61w.11 ndaanndarsti is proluwaos
<br /> tty!Zw, r,-fL;drrog t-r. nV.f1mitua-4 ta damages, costa- *xparmba, a**wmEey,s.fee-- or eqert cost-, Eyw in-Ay be dssanW try wiy
<br /> PerszP Or army -divate attorney gerwai fans 6&-rr-ed by of awarded to any patty aqwnsl e*Caumy.wI;C the County's costs awArred
<br /> i--)r7e,-"Ing an ad-Matrilt"rtqr-W*tush am not pajo by the pe4tioner
<br /> C. Eae:A as to the ccr'Anlyj rNq negft;ySnLd Or Vvlttlr rnisoonduv.
<br /> D'afor sc.
<br /> a T-r-e County may reixipat--or drwfma Caferme of any Cwm 7:)e acbonsm derin"of.a-,y,:�affr eail W, of afr,
<br /> C-D%qatiW to ir4amNty.('-eendl arr'hold""AM trle C--A'r':.i4
<br /> b, In tt�&, evrni--I a imagreerne.,T*,txawwan--Nunly r3r.1 rn-e nagar6N defense 0!aa:) C4aim.t"Ccmrdy sh.3-M Iterv-- the to comr=
<br /> 11M41'0g.wr-'1 ffrwA make b0qatiofi docwons, irw-lodir-9.tiit n0t!irrl:tea to,Lt*MSTIWIFN Wf"' !t'Odefa'Sa pa CondU--tf�d_
<br /> It C!:L.-,Iy---norabty"--wMev5 thAt t--aving cm tOt,m a prG60M sucn=jrkW vAtn a conflict of intemWl.or if!led to wumptty mrume the ddense of
<br /> army Claim Z4 to wwwjy wniov mur'$X4 nbasonaLly satisfactory to the C4LAMY ti'w County may uttze the Off" of the CCU.-Ily Counsel or enp:oy
<br /> st rata--trtuca CkouTme4 to reDtesenl ar Zafurwd the County,and I"pay Vw reawnatAe wm"WA'fees and costs of stw-+' co~r
<br /> I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THAT T14E 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 TME CALIFORNIA CONTRACTORS STATE LICEMW BOARD AND THAT I AM IN COMPLIANCE WITH ALL
<br /> WORKERS COMPERSAT10t4 LAWS.
<br /> PRr,PERT'r CMWER;
<br /> Stow PowdT, DATE
<br /> L 41 1-L-Djtj1-UAPr'-MP CONTRACTOR:
<br /> &A
<br /> S!GN: h Hennings Bic.,; CG. !:%y )#,rE Augis, 21 2t;""-'
<br /> AUTHORiZATION FOR OTHER THAN C-57SIGNM PERMIT APPLICATION
<br /> :o-3j;n this San)Oa�q=COU11TV WL11&R(Ar-ing PC=Lit Application on my bchalf. I u:txk-ntwW this nut.herwAtitin a valid for one vow.viJ
<br /> !S I.-IMICd 1D the work- plan dated on the 1runt page of this appl"tioa
<br /> tlirZM3-.4.i,zz"�" ftw 1 x: W"
<br />
|