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APPLICATION - ZONE re.ECLASSIFICATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: ZR- <br /> Other <br /> Describe any items of historical or archaeological interest on-site(e.g.cemeteries or structures): None On-site <br /> Describe any on-site or off-site sources or noise or vibration(e.g.freeway noise,heavy equipment,etc.): None on-site or off-site <br /> Describe any on-site or off-site sources of light of glare(e.g.parking lot lighting,or reflective materials used): None On-site Or Off-site <br /> Describe any on-site or off-site source of odor(e.g.agricultural wastes): None <br /> Describe any displacement of people that will be caused by the project(e.g. numbers of people,housing units): None <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 employees from any claim,action <br /> 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, grantor, or corporate officer) of the property(s) involved in this applicatio <br /> or <br /> _ Legal agent (attach proof of the owner's consent to the application of the property's involved in this application and have been <br /> authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> QUIT Z11 L_ 1 <br /> F��r✓ Date: 7 <br /> a'7 � <br /> Print Name: bN > ,Q Signature: <br /> Print Name: N/A <br /> Signature: Date: <br /> Print Name: N/A Signature: Date: <br /> Print Name: N/A Signature: Date: <br /> Print Name: N/A Signature: Date: <br /> C knmtz%mkDl­inn Annlir�l:nn 1:­7r%H:PPrA ACCIFIrATInAI Pana F of F <br />