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Qu` <br /> APPLICATION <br /> -� SITE APPROVAL, <br /> �EE_� •OG <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: SA- <br /> .�fCg4 i � � � ��„�{L F J q 3 S 1 4.-a.�' � �x{7�.� '�� -k,F 4� k -. F” I.,ty� �,aC 5�.-'.4'R' �k 1`f (C� 1 �S—�-Y }S.4 '?a�' '; -:,�'� � 4.ph F�•�. <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.q.freeway noise,heavy a ui ment,etc.): <br /> 1`C� <br /> Describe any on-site or off-site sources of light of glare(e.g.parking lot lighting, or reflective materials used): <br /> Describe any on-site or off-site source of odor(e.g.agricultural wastes): <br /> Descri a any dis lacement of people that will be caused by the project(e.g.numbers of people,housing units): <br /> r <br /> ,.�_,QNtY.THh.OWNER t)F,TI�� PROPERTX.OR AN,AUTHORIZ�ID A(�ENTi111AY FILErAN.�APP�ICATI�N ,�„�.-; <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 Owner/Agent's project. <br /> I,further, certify under penalty of perjury that'l 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 /> �r <br /> Print Name: h Signature: .rte Date: <br /> Print Name: e ; Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> I <br />