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a:�.E%•�A.c <br /> APPLICATION - USE PERMIT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> �, < FILE NUMBER: UP- <br /> Other <br /> Describe any items of historical or archaeological interest on-site e. .cemeteries or structures): <br /> N/A <br /> Describe any on-site or off-site sources of noise or vibration e. .freeway noise heavy equipment,etc. : <br /> N/A <br /> Describe any on-site or off-site sources of light of glare(e.g. parkinglot lighting,or reflective materials used <br /> There shall be a few parking lot light poles 14'-0" high with light levels to zero at the edge of the property. <br /> Describe any on-site or off-site source of odor(e.g. agricultural wastes): <br /> N/A <br /> Describe anv displacement of people that will be caused by the project e. .numbers of people,housing units): <br /> None. Open land currently <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> 1, 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 /> 1, 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. r <br /> —4 <br /> Print Name: 1ffLtYffl1fvl�5_ ,G1L-A311- Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br />