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De:. 1. 2004 2' 2UM BENNETT DEV No. 1557 K 2 <br /> APPLICATION -ZONeRECLASSIFICATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: ZR- <br /> Describe any Items of historical or archaeological interest on-site 6. .cemateries or structures): None that the av licant is <br /> aware of. <br /> Describe an n- ' or off-site sources of noise or vibration(eg-fre2M noise heavy equipment,eta: Noise iiapacts cauaed <br /> traffic activities on East Main Street, <br /> Describe any orralfa or off lte sources of 11of glare e. ,padding tot lIghting,or refleafive materials uss : None that the applicant <br /> is aware of. <br /> Describe any on-ftorcif-site source of odor 9. .agiricultureJ wastes: None that the applicant is aware of. <br /> Describe any displacement of peole that Wit be caused by the project(e.g.numbers of people,housing units: None that the <br /> applicant is aware of. <br /> im <br /> I,the OwnedAgerit agree,to dofer4 indemnify,and hold harmless the County,and its agents,offiocrs and orrployees from any claim, <br /> action or procavdirg against the OwnedAgent's project. <br /> I further certify,under penafly 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:his application, <br /> 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 /> i <br /> authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> Prim Name: L Gi ly �10YY1 r 5 t no Signature: ° q LO^^ Date: <br /> .I Print Name: Signature: Date: <br /> Print Name: Signature: _ Date. <br /> Print Name: Sigrature: _..._... . Dab: <br /> Print Name: Signature: Date: <br /> FADEVSV&Plmnino Appirztlon FomAZDNE RECLAKIF:CATION Page 5 of 5 <br /> I Rev.6-02-W <br />