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CzCl �: J''f;'• i- ,-IA¢t I�.a {i ` dL , �G G3t � 6ba 9 EA; 2 SAN JC76�.(.�l.ilN(�+JIIN Cl'C:CfviMt.Iidf'r�`FBF L1t=LUF't1Ai N r DEF'AFt�r(�4-'N'r t FILE NO: ZR- Other Describe any items of hlstorical or archacolooical interest ran-site(e(l.cemet<:rics or structures): No his oric,Si of archaeiogicai illtereSt have be on ob oryed on site. Describe any on•sile or off-site sources of noise or vibration(o.dl.free;vay noise,heavy C-quipalellt,utr Street tfaffic and Interstate 5 are sources of noise Describe any on-site or off-site sourcos of light of yLvre(e.g-parking lot ligh€ing,or rollvu lino rilaterials used): Future on Site lighting wound be directed on-site to eliminate pafetgjgc nr319in 1'10OP dies Uesrrihe any on-site or off-site source of odlor_(eI I.agric Mural wastes): __•..__ _____-__.____._____ — -�__� NFA Describe any displacement of people that will be Gatisod by the project(e.g.t unibers of peoplo.housing units) N/A. There is too-one residincl on the-propef!V..___________-_.__ ONLY THE OWNER OF THE PROPERTY OR Ail AUTHORIZED AGENT MAY FILE AN APPLICA71 ION. I,the OwnerlAgent agree,to defend,indemnify,and hold hrarmioss the County and its a{lents,officers and employees from anyulaim, action or proceeding against the County arising from the awnerlAgent's project. I furlher certify,under penalty of perjury,that I am(check ono): Q Legal property owner(owner includes partner,trustee,grantor.or corporate officer)of the properly(s)involved in this application,or Legal agent(attach proof of the owner's consent to the application of the property's involvedt in this application and have been authorized to file on their behalf,and that the foregoing application stitlenionts art true and correct. �- 3Print Name: Sign' f)atu' Priol Name: Signature: Date: Print Name: _ - __-—__-_- Signature: _--- -- _ nate: Print Name: _--. Signature: Dale- Print Nor»a: Signature: ----_--_-_._-- DatC:: r:mEvsv5Wiitw nn0 Applicnitun forma OW RECLASSIFICATION gage j of 5 Mvv.05-11-093