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APPLICATION - SITE APPROVAL <br /> ' z�.�,Ef''••oL <br /> v, SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> N: :K <br /> P FILE NUMBER: SA- <br /> Other <br /> Describe any items of historical or archaeological interest on-site(e.g. cemeteries or structures): <br /> N/A <br /> Describe any on-site or off-site sources of noise or vibration (e.g.freeway noise, heavy equipment, etc. : <br /> Two trucks will drive in and out once per day, so the effects of noise or vibration will be minimal. <br /> Describe any on-site or off-site sources of light of glare(e.g. parking lot lighting, or reflective materials used): <br /> The ad'acent business has on-site security lighting. <br /> Describe any on-site or off-site source of odor(e.-q. agricultural wastes): <br /> N/A <br /> Describe an dis lacement of DeoDle that will be caused b the ro'ect e. . numbers of eo le, housin units <br /> N/A <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 County arising from 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 /> Print Name: G( Signature: ddl `{'r Date: -Z/r4 <br /> Print Name: fi W" Signature. �' Date:��/ _ <br /> Print Name: Fe�ic�'tc�� �C Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:\DEVSVC\Planning Application Fonns\Site Approval.(Revised 02-03-10) Page 5 of 9 <br />