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0 <br /> Pqul H-- <br /> i40""` APPLICATION - USE PERMIT <br /> 0; < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> \ jFopN�i' FILE NUMBER: UP- <br /> Other <br /> Describe an items of historical or archaeolo ical interest on-site e. .cemeteries or structures): <br /> None known <br /> Describe an on-site or off-site sources of noise or vibration e. .freeway noise,heavy equipment,etc. : <br /> Project will not generate any appreciable noise on or off site. <br /> Describe an on-site or off-site sources of li ht of lore e. . arkin lot lighting,or reflective materials used): <br /> Project will not involve any new sources of light and will utilize non-reflective surfaces. <br /> Describe anv on-site or off-site source of odor e. .agricultural wastes): <br /> None. <br /> Describe an dis lacement of people that will be caused by thero'ec e. . numbers of people,housing units): <br /> None. <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 /> ❑ Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> Q 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: Justin Jones Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />