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APPLICATION — SITE APPROVAL <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ' FILE NUMBER. SA- <br /> .. ;P <br /> Other <br /> FDeswcribeitems of historical or archa ical interest on-site(e.g.cemeteries or structures):_ W H E <br /> Describe any on-site or off-site sources of noise or vibration(e.g.freeway noise.heavy equipment,etc.)-. <br /> qqI q .�'c� <br /> Fw To The "-)o�Ali <br /> [Describe any on-site or off-site sources of light of glare(e.g.parkinglot lighting,or reflective materials used <br /> 1 �5 ( 1q ht-5 o7) `)f�0 4S5e5 <br /> Describe any on-site or off-site source of odor(e-2.agricultural wastes): �C= <br /> Describe any displacement of people that will be caused by the project(e.g.numbers of people, housing units): <br /> AUTHORIZATION SIGNATURES. <br /> ONLY THE OWNER OF THE.PROP.WtTy OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, 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 Owner/Agent's project. <br /> 1, 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 /> Ej Legal agent (attach proof of the owners 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 /> � , Signature:Print Name: ��_(f� ate: t O G <br /> Print Name: Signature: Date.- <br /> Print <br /> ate:Print Name: Signature: pate: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Bate: <br /> F IDEVSVC-Planning Appiicatmn Formd0ite Approval-(Revised"3-04) Page 5 of 9 <br />