Laserfiche WebLink
APPLICATION - SITE APPROVAL <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> i•,_. FILE NUMBER: SA- <br /> Other <br /> Describe any items of historical or archaeological interest on-site e. .cemeteries or structures): <br /> None <br /> Describe any on-site or off-site sources of noise or vibration(e.g.freeway noise, heavy equipment,etc. : <br /> Forklifts , Trucks, Dust System <br /> Describe any on-site or off-site sources of light of glare(e.g. parkinglot lighting,or reflective materials used): <br /> No new outdoor lighting fixtures anticipated at this time <br /> Describe any onsite or off-site source of odor(e.g.a hcultural wastes): <br /> None <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 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: �InS�Fii /h [r_J Signature: p�L S /t!_. Date: <br /> Print Name: Signatu (/' Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date. <br /> Print Name: Signature: Date: <br /> F:VEVSVC1Planning Application Forrnsl8fle Approval.(Revised 02-0310) Page 5 of 9 <br />