Laserfiche WebLink
APPLICATION SITE AP <br /> PROVAL <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ;. ' <br /> FILE NUMBER: SA- <br /> Other <br /> Fanyon-site <br /> al or archaeological interest on-site(e.g.cemeteries or structures): None <br /> e sources of noise or vibration (e.g.freeway noise, heayy equipment, etc. : Forklift and baler use <br /> will result in some noise, though this will be limited primarily to inside the building. Highway 99 causes some off-site noise. <br /> Describe an on-site or off-site sources of light of glare(e.g. parkinglot fighting, or,reflective materials used): None <br /> Describe an on-site or off-site source of odor(e.g. agricultural wastes): None <br /> Describe any displacement of people that will be caused by the ro'ect(e.g. numbers of pe2ple, housing units): 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: (A-,�`•Q �i�C►ter. Signature: � , � ii - <br /> Date: <br /> Print Name: Signature: <br /> Date: <br /> Print Name: <br /> Signature: Date: <br /> Print Name: <br /> Signature: /e e Date: <br /> Print Name: Signature: <br /> Date: <br /> =1DEVSVC1PIannin9 Application Forms\SiteApproval.(Revised 05-11-09) Page 6 of 9 <br />