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APPLICATION - SITE APPROVAL <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: SA- <br /> Other <br /> Describe any items of historical or archaeological interest on-site(e.g. cemeteries or structures): <br /> /S/ONF <br /> Describe any on-site or off-site sources of noise or vibration (e.g.freeway noise, heavy equipment, etc. : <br /> i�A/ rAAd �vOisf fvErq �1 6i c9r3. elf ��c� wig/cYi/ _ivEiyTi� tiois� <br /> AssouA�c/ uri� co�,v xrs icis.�.� � �i ��� G9G�.vE7j Sir»i/�r� �s�,q// /�Y4C'ucyr <br /> Describe any on-site or off-site sources of light of glare(e.g. parkinglot lighting, or reflective materials used): <br /> 117 / <br /> Describe any on-site or off-site source of odor(e.g.a ricultural wastes): <br /> Describe any displacement of people that will be caused by the project(e.g. numbers of people, ousing 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 <br /> employees from any claim, action or proceeding against the Owner/Agent's project. <br /> I, 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: /�'�N�� ��5� Signature: Date:��Z•Z <br /> Print Name� � f�� �� O�s Signature: Date: <br /> Print Name: ri�Q �` Signature: Date: <br /> Print Name: Signature: Date: <br /> I <br /> Print Name: Signature: Date: <br />