SU0012240 - Laserfiche WebLink

Home Browse Search

APPLICATION - USE PERMIT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT FILE NUMBER: UP- Other Describe any items of historical or archaeological interest on-site e. .cemeteries or structures): Describe any on-site or off-site sources of noise or vibration e. .freeway noise,heavy equipment, etc. : rh Ll�' Describe any on-site or off-site sources of light of glare e. .parldng lot lighting,or reflective materials used): Describe any on-site or off-site source of odor(e.g, agricultural wastes): NONE Describe any displacement of people that will be caused by the project e. . numbers of people, housing units): MD�E AUTHORIZATION SIGNATURES ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County-and its agents, officers and employees from any claim, action or proceeding against the County arising from the Owner/Agent's project. I, further, certify under penalty of perjury that I am (check orae): ❑ Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) involved in this application, or VLegal agent(attach proof of the owner's consent to the application of the-property's involved in this application and have been authorized to file on their beha ., nd that the foregoing application statements are true and-correct. Print Name: Lr-_ro k S .CTY>,—t"rt) Signatu Date: e: Print Name: Signatu Date: Print Name: Signature: Date: Print Name: Signature: Date: Print Name: Signature: Date: