Laserfiche WebLink
APPLICATION - USE PERMIT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> .{! FILE NUMBER: UP- <br /> Other <br /> Describe any items of hislorical or archaeological interest on-site e. .cemeteries or structures): <br /> N/A <br /> Describe any on-site or off-site sources of noise or vibration e. .freeway noise heavy equipment,etc.): <br /> Train engine cars, typical trucking, similar to previous use <br /> Describe any on-site or off-site sources of light of glare e. .parking lot lighting,or reflective materials used): <br /> Parking Lot Lighting, similar to previous use <br /> Describe any on-site or off-site source of odor e. .agricultural wastes): <br /> N/A <br /> Describe any displacement of people that will be caused by the ro'ect e. .numbers of people,housing units): <br /> N/A <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 <br /> employees from any claim, action or proceeding against the County arising from the Owner/Agent's project. <br /> 1,further, certify under penalty of perjury that I am(check one): <br /> © Legal property owner(owner includes partner, trustee,trustor,or corporate officer)of the property(s) <br /> involved in this application, or <br /> ❑ Legal agent(attach proof of the owner's consent to the application of the property's involved in this <br /> application and have been authorized to file on their behalf., and that the foregoing application statements <br /> are true and correct. <br /> Print Name: Nicholas Bancroft signature: _ V Date:5/22/12 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F ADFvsvctPtenMng AppksHon FormslUse Permit.laeNsed 02-03-10t Page 5 of 9 <br />