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*07/06/2009 09:41 FAX 2093394822 SYCAMORE LANE KENNEL, 001/nut <br /> a moo. <br /> APPLICATION - USE PERMIT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: LIP- <br /> 1111`111E <br /> VIIMTIi Toi,111 I JIRi�E'li �111101;RR'� <br /> Describe any items of historical or archaeolo!plcalinterest on-site(e.o.cemeteries oratiuctums): <br /> Describe any on4te or off-site sources of noise or vibration(e.o.freeway noise,heavy equipment, etc.): <br /> Describe any on-site or off-site sources of lioht of glare(e.n.parking lot lighting,or refle,:tive materials used): <br /> S 7f <br /> Describe any on-site or off-site source of odor(e.g.marloultural wastes): <br /> L.xat,f- LL&W To iAoAu <br /> Describe any displacement of people that will be cauescl by the project(e.g.numbers of people, housing units): <br /> b lei <br /> 1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County end 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 /> El Legal property owner(owner Includes partner,trustee, trustor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> El 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: AU/9 1.4 <br /> Date:,} _6 <br /> Print Name: Signature: Date: <br /> Print Name; Signature: Dale: <br /> PAM Name: Signature: Date: <br /> Print Name, Signature: Data: <br /> F%0EVSVCT1snTflng ApplIcadon FomskUEe Pqrmlt.(RavlaBd 05-11-0a) Page 5 of 9 <br />