Laserfiche WebLink
ip <br /> Other APPLICATION - SITE APPROVAL <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: SA- <br /> Describe any items of historical or aruhaeolagical interest on-site e. .cemeteries or structures): <br /> n/a <br /> Describe any on-site or off-site sources of noise or Vibration e.g-freeway noise heavy a ui ment,etc.: f <br /> adjacent to 1-5 freeway <br /> Describe any on-sits or off-site sources of light of glare e. .parking lot lighting,or reflective materials used). <br /> proposed new parking and security lighting <br /> Describe any ort-site or off-site source of odor(ep.agricultural wastes): <br /> n/a <br /> Describe arW displacement of people that vrill be caused by the project e. .numbers of people,houslnq units): <br /> n/a <br /> AUTHORZATION 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: y`0= /0, (i)CE Signature: Date: ,yLS <br /> Print Name: Signature: Date: T� <br /> Print Name: Signature: Date: <br /> PrIntName: Signature: Date: <br /> Print Name: Signature: Date: <br /> F-MEV5VCV9aming App`Jcatlon Farmslalte Approval.(navissl 02-03-70) Page 5 of 9 <br />