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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 archaeol ical interest on-site(e.g-cemeteries or structures): <br /> on <br /> Describe any on-site or off-site sources of noise or vibration(e.q. freeway noise,heavy equipment.etc.): <br /> none- -u_nj <br /> Describe any on-site or off-site sources of light of glare(e.g- parking lot lighting,or reflective materials used): <br /> n-D <br /> sed : <br /> D <br /> Describe any on-site or off-site source of odor(e.g-agricultural wastes): <br /> Describe any displacement of people that will be caused by the project e.S.numbers of people, housing units): <br /> --fax) 5,k le_. t m i� Its <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. y�,� 9--2o-0-7 <br /> Print Name: 0c e/c6&—, /!`r ///p- �e Signature: Date: <br /> Print Name: t ignature: Date: ' v U <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F_1DEVSVQPlanning Application FormsMe Approval.(Revisal 603-04) Page 5 of 9 <br />