Laserfiche WebLink
APPLICATION -- USE PERMIT <br /> SAN JOAQUIN COUNTY COMMUNITY DE=VELOPMENT DEPARTMENT <br /> :r <br /> FILE NUMBER: UP- <br /> Other L <br /> Describe an items of historical orarchaeoloq ical interest on-site(e.g.cemeteries or structures): <br /> None. <br /> Describe an on-site or off-site sources of noise or vibration(e.g.freeway noise,heavy equipment,etc. ., <br /> 1-5 approximately 1 mile to east. <br /> Describe an on-site or off-site sources of li ht of glare Je.g.parking tot lighting,or reflective materials used): <br /> None. <br /> Describe an on-site or off-site source of odor(e.g.agricultural wastes): <br /> Lodi Wastewater Treament Plant, east of property. <br /> Describe any displacement of people that will be caused by the project(e.g.numbers of people,housing units): <br /> None. <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED.AGENT MAY FILE AN APPLICATION. <br /> 1, 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: Alex G_ Span_o s Signature: — Date: 2/21/0 <br /> Signature: Date: <br /> Si <br /> Print Name: 9 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F.M)EV5VCXPIann1ng Application Formswse Permit.(Revised 6-03-04) Page 5 of 9 <br />