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APPLICATION — SITE Ai ■ ROVAL <br /> .� SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> r <br /> FILE NUMBER: SA- <br /> I <br /> Other <br /> Describe an items of historical or archaeological interest on-site(e.g. cemeteries or structures): <br /> NONE <br /> I <br /> i Describe any on-site or off-site sources of noise or vibration(e.q.freeway noise, heavy equipment, etc, : <br /> NONE <br /> Describe any on-site or off-site sources of light of glare(e.g.parkinglot lighting,or reflective materials used): <br /> PARKING LOT LIGHTING; FACILITY LIGHTING (e.g,STRUCTURE LIGHTS, YARD LIGHTS) <br /> f Describe any on-site or off-site source of odor(e.g.agricultural wastes): <br /> NONE <br /> Describe any displacement of people that will be caused by the project Ce.q. 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 /> 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 /> i <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: GEORGE T. CAMPBELL <br /> Signature: Date: 4/21/10 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: <br /> Date; <br /> Print Name: Signature: Date: <br /> F:MEVSVOPlanning Appkailon Forms%Site Approval.(Revised 05-11-09) Page 5 of 9 <br />