SU0005918 - Laserfiche WebLink

Home Browse Search

2: APPLICATION - ITE APPROVAL SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT �..aC. ,.;4.. 4�•,F�.�r FILE NUMBER: SA- N4x�1u , .'+��r��l�f.;.. ,i-�.�� r v i � '' n w� :a ��,vwv, �` '•;nam r f ' k �;, � y, '''� 2'y §+� r��d'}�` i t'��m��rM�a �fid'.. `'��F�::„�.�"'nu .r r!,.. �C.. Ir._ i•-, _ r-1.ec Y�SQ��s:.7.�. 5,a.,,> Yv_ e -�a " 4��k•'1}. �[� $�';��f a?�E7�s� k�b �Wla - -, _ -.^v: „ors.i. +.d.�a.��..- ^{•.L .rrN. ��r.1 Describe any itorns of histori.caf;or archaeological interest ora=s.ite(e.g. cemeteries or.structures : N vJ E Describe any on-site or off-site source's of noise or vibration (e.g.freeway noise, hea a tii rnent, etc.): rJ©taG , Describe any on-site or off-site sources of light of glare (e.g. parkinglot lighting,or reflective materials used): O+ti Describe any on-site or off-site source of odor(e.g.agricultural wastes): C n Describe any displacement of Peovle that will be caused by the 2roject(e.g. numbers of eo le, housing units): N N AUTHORIZATION SIGNATURES ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the county and its agents, officers and employees from any claim, action or proceeding against the Owner/Agent's project. I, further, certify under penalty of perjury that I am (check one): ❑ Legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) involved in this application, or Q' Legal agent (attach proof of the owner's consent to the application of the property's involved in this application and have been authorized to file on their behalf., and that the foregoing application statements are true and correct. Print Name: �Ov�n _ � q�-� Signature: Date: 11 Print Name: Signature: Date: Print Name: Signature: Date: Print Name: Signature: Date: Print Name: Signature: Date: aDEVSVC%Planning Application Forms\Site Approval.(Revised 1-3-03) Page 5 of 9