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1 <br /> . I <br /> 4ib <br /> APPLICATION — SITE APPROVAL <br /> 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 /> No NIVE <br /> Describe any on-site or off-site sources of noise or vibration e. .freeway noise heavy a ui ment,etc.): <br /> NC9 N F- <br /> Describe any on-site or off-site sources of light of glare e. .parking lot li hun ,or reflective materials used): <br /> Describe any on-site or off-site source of odor e. .a ricultural wastes): <br /> fg <br /> Describe any displacement of people that will be caused by the promect e. . numbers of people,housin 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� <br /> �i�� wL�It�7S Signat re: " `��� �'"`�'a� Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />