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APPLICATION - ZONE RECLASSIFICATION <br /> e' SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> p.. FILE NO: ZR- <br /> 1F0 <br /> Other <br /> Describe any items of historical or archaeological interest on-site(e.g. 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 /> Traffic noise from State Route 12;farming equipment seasonal <br /> Describe any on-site or off-site sources of light of glare e. .parking lot lighting, or reflective materials used): <br /> Headlights from traffic on the highway. <br /> Describe any on-site or off-site source of odor e. . agricultural wastes): <br /> None <br /> Describe any displacement of people that will be caused by the project e. . 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 employees from any claim, <br /> 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,grantor,or corporate officer)of the property(s)involved in this <br /> application, or <br /> ❑ Legal agent(attach.proof of the owners consent to the application of the property's involved in this application and have been <br /> authorized to file on their behalf., and that the foregoing application statements are true and correct <br /> Print Name: C K K t S 4t nID LL Signature: Date: <br /> Print Name:'D z AN E`.�� J<fJ®E—C— Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:IDEVSVS1Planning Application Fonns\ZONE RECLASSIFICATION Page 5 of 5 Project No. 17110 <br /> (Rev.05-11-09) <br />