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0.4u(n APPLICATION — SITE APPROVAL <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> "q.., . FILE NUMBER: SA- <br /> Other <br /> Describe any items of historical or archaeological interest on-site e. .cemeteries or structures): No likely cultural <br /> resources are apparent from the available maps, data or known history. <br /> attachedSee r ct descrir)tion for additional information. <br /> Describe any on-site or off-site sources of noise or vibration e. .freeway noise,heavy equipment,etc. : Construction <br /> activities will produce noise during business hours. After construction <br /> no noise will be apparent on adjacent properties. <br /> Describe any on-site or off-sRe sources of light of glare e. .parking lot lighting,or reflective materials used): See prolect <br /> description for additional information regarding this topic. <br /> Describe any on-site or off-site source of odor e. .agricultural wastes):The pro ect will not produce any <br /> discernible levels of any odors . <br /> Describe any displacement of people that will be caused by the project e. .numbers of people,housing units): The project <br /> will only result in the displacement of the current landowner, which is <br /> willing seller of the property. <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 /> © 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: CNPurn101J ts7Z /a r7"f-t—� Signature: Date: 11 171 lZ <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FADEVSVQPIanning Application Fonns\Sita Appn 1.(Revised 02-0&10) Page 5 of 9 <br />