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APPLICATION — SITE APPROVAL <br /> < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ••i<•• FILE NUMBER: SA- <br /> Other <br /> Describe any items of historical or archaeological interest on-site e. .cemeteries or structures): <br /> 6 n <br /> Desoribe any on-site_or off-site sources of noise or vibration e. .freewaynoise,heavyequipment,etc. : <br /> o^l <br /> Describe any on-site or off-site sources of light of glare e. .parking lot Ii htin ,or reflective materials used): <br /> %,-1%-` e ) tfoo W T� <br /> ovcw r g-s: �� lUrrvrn� G�ac�F <br /> Describe any on-site or off-site source of odor e. .agricultural wastes): <br /> Describe any displacement of people that will be caused by the project e. .numbers of people,housing units): <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: / Signature: Date: <br /> e ► <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F\DEVSVQPWning ApphpGon Farms\Site Approval.(Revis 02-03-10) Page 5 of 9 <br />