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I <br /> APPLICATION -- ZON ECLASSIFICATION <br /> 14- <br /> = lk <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> t.. - ! ] FILE NO: ZR- <br /> , Other ,..71 <br /> Describe any items of historical or archaeological interest on-site (e.g. cemeteries or structures): <br /> Not known <br /> i <br /> i <br /> I Describe any on-site or off-site sources of noise or vibration (e.g.freewa noise, heavy e ui ment, etc.): <br /> Freeway nozse <br /> i <br /> Describe any on-site or off-site sources of Fight of glare(e.g. parking lot lighting, or reflective materials used): <br /> None <br /> i <br /> Describe any on-site or off-site source of odor(e.g. agricultural wastes): <br /> None <br /> i <br /> Describe any displacement of people that will be caused by the project(e.g. numbers of people, housing units): <br />` None <br /> AUT <br /> ' HORIZATI0N 91GN4TURES <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 <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: i'J�Vj� G' s 1 Signature: Date: <br /> Print Mame: Signature: Date: <br /> Print Name: Signature: Date: <br /> I <br /> t Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> a <br /> F-VDFVSVS\Planning Application ForrnsIZONE RECLASSIFICATION Page 5 of 5 <br /> (Rev-04-25-05) <br />