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APPLICATION - ZONE RECLASSIFICATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: ZR------ <br /> .......... <br /> R- __ <br /> Gt•., ... <br /> L%P ORa <br /> i F t <br /> Ike, 1 <br /> { 67776 fl.,g'n Yiks. rY ..a r <br /> Describe an items of historical or archaeological interest on-site e. .cemeteries <br /> None <br /> Describe an on-site or off-site sources of noise or vibration e. .freewaynoise, heavyeq ui ment,etc.): <br /> Freeway is to East of site <br /> r <br /> ibe an on-site or off-site sources of li ht of lare e. . arkin lot li htin ,or reflective materials used : <br /> parking lights on site will have shield plate-to keep the glare within the site <br /> ibe an on-site or off-site source of odor e. . a ricultural wastes : <br /> ne <br /> Describe any displacement of people that will be caused by the project e. . numbers of people,housi2q units): <br /> None Ty�yp <br /> AUTH UZA rn i x 'i 3 ,J`Ih Ls n z., <br /> rtheOwner/Agent <br /> LY THE OWNtWOF THE PROPERwY Ok A1ITHOR �ANAY =ItP�UGR.. x <br /> agree,to defend, indemnify,and hold harmless the County and its agents,offcers and employees from any claim, <br /> ceeding against the County arising from the Owner/Agent's project. <br /> tify,under penalty of perjury,that I am(check one): <br /> gal property owner(owner includes partner,trustee,grantor,or corporate officer)of the property(s)involved in this <br /> plication,or <br /> ❑ Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and have been <br /> authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> Print Name: GLLpreet S' gh Well <br /> Signature: � Date: (v <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:\DEVSVS\Planning Application Forms2ONE RECLASSIFICATION Page 5 of 5 <br /> (Rev.05-11-09) <br />