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APPLICATION - ZON RECLASSIFICATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: ZR- <br /> Other <br /> Describe any items of historical or archaeological interest on-site(e.g.cemeteries or structures): <br /> 0 1-i <br /> Describe any on-site or off-site sources of noise or vibration(e.g.freeway noise, heavy equipment,etc. : <br /> Describe any <br /> 'on-site or off-site sources of light of glare e. . parkinglot lighting, or reflective materials used): <br /> N tJ 0- <br /> Describe any on-site or off-site source of odor(e.g. agricultural wastes): <br /> �,I 'e> M <br /> Describe an displacement of people that will be caused by the project(e.g. numbers of people,housing units): <br /> ( r UN r V1 r._L.-- SS �ct-- L_tSN <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 employees from any claim, <br /> 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,grantor,or corporate officer)of the property(s)involved in this <br /> application, or <br /> Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and have been <br /> authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: L--AS4Z9ZI 1',{1ATW,4Ia _% Signatur Date: 4/74/0 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:\DEVSVS\Planning Application Forms\ZONE RECLASSIFICATION Page 5 of 5 <br /> (Rev.04-25-05) <br />