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r pquty <br /> APPLICATION - SITE APPROVAL <br /> < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> •• ti p FILE NUMBER: SA- <br /> ��FotR� <br /> Other <br /> Describe any items of historical or archaeological interest on-site e. .cemeteries or structures): <br /> None <br /> Describe anv on-site or off-site sources of noise or vibration e. .freeway noise, heavy equipment,etc. : <br /> Hwy 99 is directly to the East of the site, which generates noise; however <br /> it will not affect the proposed use . <br /> Describe any on-site or off-site sources of light of glare e. . parking lot lighting,or reflective materials used): <br /> There may be some off-site light from neighboring properties or the Hwy. <br /> On—site lighting will be shielded to avoid glare and spill on neighbors . <br /> Describe any on-site or off-site source of odor e. . agricultural wastes): <br /> There may be odors from Hwy 99, but it will not affect the proposed use . <br /> The proposed use will not generate any foreseen uncontrolled odors . <br /> Describe any displacement of people that will be caused by the project e. . numbers of people, housing units): <br /> There are no dwellings or buildings being displaced by this proposed <br /> project . <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 /> ❑x 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.Vame: 0L�lf Cezz Signature:,'_0&2g.2:L Date: t—. ! <br /> FrinlName: /i1 s;�e"t' Signature: ��u - D. <br /> Print Name, Signature: Date: <br /> Print Name_ Signatrrre: Date: <br /> Print Namw Signature: Date. <br /> F:\DEVSVD\Planning Application Forms\Site Approval.(Revised 02-03-10) Page 5 of 9 <br />