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APPLICATION - ZOO RECLASSIFICATION ,• <br /> SAN JOAOUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> s ?• <br /> FILE NO: <br /> IMS ^""n .a 3. x j r :i• ,11�+, .i .�s��y-:, Y ..ter sA5 ... 'm' r£C � i? "��Y <br /> .a <br /> . Qescribe alt. items.of-historical or archaeolo laai interest on-s�#� e ,oemeteries or structure§ <br /> Describe any.on-site oroff-site sources'ofnolse or°Vib'ration, e. frepWa noise;,hea e-ui'merit,etc:: ::. _ <br /> Describe any art-site or.off=site:sources of light of glare. e.gi..par.king lot lighting,or reflective materials used): <br /> Describe any on-site or off-site source of odor(e.g.agricultural wastes): 6 tJ <br /> a <br /> Describe any displacement of people that will be caused by the project(e.g.numbers of people,housing units): r7. <br /> AIJTHtIATIbN $IG TORE$ <br /> ONLY THE OWNER OF,THE PRbPERTY OR ANyoiUTH <br /> ORI Eb AGENT MAY FILE AN -APPLIcATION.' <br /> I,the Owner/Agent agree,to defend,indemniN,'dnd hold harmless the County and its agents,officers and employees from any claim, <br /> action 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 Icer)of the property(s)involved in this <br /> application,or <br /> ❑ Legal agent(attach proof of the owner's consent to the application of t roperty's involved in this application and have been <br /> authorized to file on their behalf.,and that the foregoing application ments are true and correct. <br /> Print Name: ,/CJ— L, ���i� Signature: _ Date: <br /> Print Name:Name: Signature: Date: . <br /> Print Name: Signature: _ Date. <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:IDEVSVMPlannhg Application Forms\ZONE RECLASSIFICATION Page 5 of 5 <br /> (Rev.6-02-04) <br />