Laserfiche WebLink
r <br /> �✓rCN <br /> APPLICATION - SITE APPROVAL <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ,`� t,� `4• FILE NUMBER: SA- <br /> Describe any items of historical or archaeological interest on-site(e.g.cemeteries or structures), <br /> Describe any on-site or off-site sources of noise or vibration(e.g.freeway noise, heavy equipment,etc. : <br /> t�7 <br /> Describe any on-site or off-site sources of light of glare(e.g. Rarkinglot fighting,or reflective materials used): <br /> I Describe any on-site or off-site source of odor(e.g.agricultural wastes): <br />,t <br /> Describe any displacement of people that will.be caused by the ro'ect(e.g.numbers of people, housing units): <br /> i <br /> ,O <br /> AUTHOPIZATIOWSIGI ATU€PES <br /> ONLY THE CSWNEF -OF THE„PROPERTY OR AN ,4lJ ,fl I b,AGENT M,,,AY:IFILE;AN,AP.Pt_CCATION: <br />'j 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 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 apRlication of the property's involved in this <br /> application and have been authorized to file on their be I , and that the foregoing application statements <br /> are true and correct. <br /> Print Name:. �� signature: Date:-Z <br /> i Print Name: Signature: Date: <br /> ! <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Dater <br /> Print Name: Signature: Date: <br /> F:IDEVSVCIPTanning Application FormslSite Approval.(Revised 6-03-04) Page 5 of 9 <br />