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x I = <br /> APPLICATION - SITE APPROVAL <br /> P. SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER:\ SA- <br /> irtoat <br /> x <br /> Other. .'.'..:, s, ry %.,,,.,(._.'. I• .,. <br /> E <br /> ms of historical or archaeolo ical interest on-site e. . cemeteries or structures : <br /> -site or off-site sources of noise or vibration (e.g.freeway noise, heavy equipment, etc. : <br /> Frontage to 99 Hwy South <br /> Describe any on-site or off-site sources of light of glare (e.g. parkinglot lighting,or reflective materials used): <br /> %aaek PHRKING LIGHT ON BUILDONG <br /> Describe any on-site or off-site source of odor(e.g. agricultural wastes): <br /> UNKNOWN <br /> Describe any displacement of people that will be caused by the project(e.g. numbers of people, housing units): <br /> 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 <br /> employees from any claim, 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, 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 fore oing application statements <br /> are true and correct. <br /> Print Name: Yvan J . Albert Signature: Date: 4,/15j/2008 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F\DEVSVC1Planning Application Forms�,Siie Approval.(Revised 1-3-03) Page 5 of 9 <br />