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' u rte- o r >°per r ;w . APPLICATION - SITE APPROVAL SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT / FILE NUMBER: SA- \i�oR°' 4 'Other Describe any items of historical or archaeological interest on-site(e.g. cemeteries or structures): None Describe any on-site or off-site sources of noise or vibration (e-g.freeway noise, heavy equipment, etc. : State Highway Route 99 is adjacent to subject parcel. Describe any on-site or off-site sources of light of glare(e.Q. parkinglot lighting, or reflective materials used): Existing site had lighting. The future development will also have on-site,low glare lighting, Describe any on-site or off-site source of odor(e.g. agricultural wastes): None F Describe any displacement of people that will be caused by the project(e.g. numbers of people, housin units): None AUTHORIZATION SIGNATURES 4 ONLY THE OWNER OF THE.:PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees from any claim, action or proceeding against the Owner/Agent's project. E, further, certify under penalty of perjury that I am (check one): ® Legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) involved in this application, or I ❑ Legal agent (attach proof of the owner's consent to the application of the property's involved in this 4 application and have been authorized to file on their behalf., and that the foregoing application statements are true and correct. Print Name: Signature: Date: Print Name-. Signature: Date: Print Name: Signature: Date: i Print Name: Signature: Date: Print Name: Signature: Date: F:IDEVSVC\Planning Application Forms\Site Approval.(Revised 6-03-04)Page 5 of 9 Project No. 0513