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q <br /> z;• _ G. <br /> �n ! SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> at <br /> �.• . m_ . �: FILE NUMBER : UP - <br /> 14 1 <br /> Other - <br /> Describe -anv items of historical or archaeological interest on -site (e . g . cemeteries or structures ) k <br /> Describe any on -site or off-site sources of noise or vibration (e . g . freeway noise , heavy equipment , etc . : <br /> Describe any on-site or off-site sources of light of glare (e . g . parkinglot lighting , or reflective materials used ) : f.3 <br /> Describe any on -site or off-site source of odor (e . g . agricultural wastes ) : Eye <br /> Describe any displacement of people that will be caused by the project ( e . g . numbers of people , housing units) , <br /> AUTHORIZATION SIGNATURES <br /> ONLYT <br /> HE OWNER OF THE PROPERTY QR 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 : � � ��� t (4 CI f Signature : Date : <br /> Print Name : Signature : Date . <br /> Print Name : Signature : Date : <br /> Print Name . Signature : Date . <br /> Print Name : Signature : Date : <br />