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°g4�1y APPLICATION - ;SITE APPROVAL <br /> r � <br /> ' c SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> � . FILE NUMBER: SA- <br /> Other <br /> Describe any items of historical or archaeological interest on-site e. .cemeteries or structures): <br /> /t)S ,d <br /> Describe any on-site or off-site sources of noise or vibration (e.g.freeway noise, heavy equipment, etc. : <br /> d2 (, -( <br /> Describe any on-site or off-site sources of light of glare e. .parking lot lighting,or reflective materials used): <br /> Ab vc <br /> Describe any on-site or off-site source of odor e. . agricultural wastes): <br /> remployees <br /> displacement of people that will be caused b the project(e.g. numbers of people, housingunits): <br /> AUTHORIZATION SIGNATURES <br /> OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> m any claim, action or proceeding against the Owner/Agent's project. <br /> ify 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.r <br /> Print Name: / ,drr� Ab,y-`NeZ Signatur r Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F 1DEVSMPlanning Application Forms\Site Approval.(Revised 09-10-08) Page 5 of 9 <br />