SU0006700 - Laserfiche WebLink

Home Browse Search

APPLICATION —SITE APPROVAL SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT FILE NUMBER: SA- i Other.h Describe any items of historical or archaeological interest on-site (e.g.Gemeteries or structures): Describe any on-site or off-site sources of noise or vibration (e.g.freeway noise, heavy equipment, etc.): Otis I TE - V C 0 1,--L-F-S i" "Iii ic 5 5"c>(> 4" F 21c r W4=>I S E 114 METAL. .5140P. CFrSi-rE - FREFEWAY $ A,1 RP a-r t4o Describe any on-site or off-site sources of light of glare(e.g. parking lot lighting,or reflective materials used): A t-JT1 e I P ATF- ki.ASTA,L-L %"6 APP12VIEO 'S-T R F-F-1- L 16 I-kTS Poi ,-JTF-E) W4cZO iiij 5TK2saAeF- AWCA, Li/-,H-rS AeE APPPoxi",&-r-lEL.Y 15 ' Describe any on-site or off-site source of odor(e.g. agricultural wastes): 1J,011-AE E)<pIll Describe any displacement of people that will be caused by the project (e.g- numbers of people, housing units): rJo'i F- AUTHORIZATION SIGNATURES ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. 1, 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. 1, 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 F] Legal agent (attach proof of the owner's consent to the application of the property's involved in this application and have been authorized to file on their behalf., and that the foregoing application statements are true and correct. Print Name: i t.46 Dftfp- 4L7AIa , Signature ZV2A Date: 7 Print Name: L9L(3A- iuf/' e) l Signature: 61.4 Date: Print Name Signature: Date: Print Name: Signature: Date Print Name: Signature: Date: F 0EVSVC\Planning Application FormsiiSde Approval (Revised 1-3-03) Page 5 of 9