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"fluty SITE IMPROVEMENT PLAN <br /> a � < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> c FILE NUMBER: IP- <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> West Sugar Drive 30.5' 30.5' Yes ❑ No I Yes❑ No [� <br /> South Holl Drive 45' 45' <br /> Y Yes ❑ No Yes❑ No <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 /> x❑ 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: Steve Cortese Signature: Date: 3 8' Z4 17 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:\DEVSMPlanning Application Forms\Site Improvement Plan, Page 4 of 9 <br /> (Revised 8-13-13) <br />