Laserfiche WebLink
4-U. <br /> '``° APPLICATION - SITE APPROVAL <br /> t SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: SA- <br /> 9�rFOR��P <br /> Other <br /> Describe anv items of historical or archaeological interest on-site e. .cemeteries or structures): <br /> Describe any on-site or off-site sources of noise or vibration e.gi freeway noise, heavy equipment,etc. : <br /> v 6rtmqu a1tx i"F- - t G <br /> w 2 <br /> Describe any on-site.or off-site sources of light of glare e. .parking lot lighting,or reflective materials used): <br /> e.Y t44.. S t-C 2- Lk-CNV t-1 N A14 D S*Z)e.--- K3 <br /> Describe anv on-site or off-site source of odor e. .agricultural wastes): <br /> DkAF_ R-`Ar—S O o-VJ4-1-R.T4\4N 1-4+8 SW�4..LL <br /> Describe any displacement of people—that will he caused bv the project e. . numbers of people,housing units): <br /> NrZ t k.61 LL giSsf C-Z- 17 N5 <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 /> 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: � f-t '{rl�$IvG1'�. Signature: Date: —(0 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FADEVSVC\Planning Application Fonns�Site Approval.(Revised 02-03-10) Page 5 of 9 <br />