Laserfiche WebLink
t" APPLICATION - SITE APPROVAL �- <br /> 2 - <br /> ' < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: SA- <br /> rrFOQ <br /> l Other <br /> 1 <br /> Describe any items of historical or archaeological interest on-site(e.g.cemeteries or structures): Nona. <br /> �. <br /> Describe any on-site or off-site sources of noise or vibration(e.g.freew ay noise heavy equipment,etc. : t <br /> r <br /> Describe any on-site or off-site sources of light of glare e. .parking lot lighting,or reflective materials used): Non, <br /> f <br /> I <br /> ( <br /> Describe any on-site or off-site source of odor e. .agricultural wastes): <br /> ur <br /> { <br /> r- <br /> i <br /> Describe any displacement of people that will be caused by the project e. .numbers of people,housing units): <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 foregoing application statements <br /> are true and correct. <br /> O <br /> Print Name: —22 (' Signature: Date: IZ <br /> Print Name: rSignature: Date: ` C( <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FADEMCWlanning Application FormsZole Approval.(Revised 1-"3) Page 5 of 9 <br />