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C--%Oet� <br /> APPLICATION - ZONE RECLASSIFICATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: ZR- <br /> mer <br /> Farhistorical orarehaeolo ical interest on-site e. .cemeteries or structures): <br /> i <br /> r off-site sources of noise or vlbration e. .freewaynoise,heavyui ment,etc.): <br /> ) <br /> otf-site sources of li ht of aro e. .parking lot fighting,or reflective materials used <br /> Describe any on-site or off-site source of odor(e.g.agricultural wastes): <br /> Describe an displacement of people that will be caused b the project e: .numbers of people,le,housin g units): <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I,the Owner/Agent agree,to defend,indemnify,and hold harmless the County and its agents,officers and employees from any claim, <br /> action or proceeding against the County arising from the Owner/Agents project. <br /> I further certify, under penalty of perjury,that I am(check one): <br /> Legal property owner(owner includes partner,trustee,grantor,or corporate officer)of the property(s)involved in this <br /> application,or <br /> ❑ Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and have been <br /> authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: I \C�YtJ KI '►'tI Signature: Date:d8ro7 /18 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> i <br /> RSVS\Planning Application FormsIZONE RECLASSIFICATION Page 5 Of 5 <br /> (Rev. <br /> a <br /> (Rev.05.1 1-09) <br /> i <br />