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-p =5% <br />SITE IMPROVEMENT PLAN <br />SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br />FILE NUMBER: IP - <br />Existing Roads <br />Road/Street Name <br />R.O.W. Width <br />Pavement Width <br />Curb/Gutter <br />Sidewalks <br />South Bird Road <br />32 feet <br />22 feet <br />Yes ❑ No ® <br />Yes ❑ No <br />Yes ❑ No ❑ <br />Yes ❑ No ❑ <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 />7x Legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br />involved in this application, or <br />X❑ 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: Take Hinchey Signature: _ Date:10-7-2019 <br />Date: <br />Print Name: Warren Coalson, Agent Signature: <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />F:\DEVSVC\Planning Application Forms\Site Improvement Plan. Page 4 of 9 <br />(Revised 8-13-13) <br />