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° PQU � Itym a at & APPLICATION — ZONE RECLASSIFICATION _:. � SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT c� • . , . 0 FILE NO : ZR- 4 � � FOR � Other Describe any items of historical or archaeological interest on -site (e . g . cemeteries or structures ) : nothing known of Describe any on -site or off-site sources of noise or vibration ( e . g . freeway noise , heavy equipment , etc . . E Main Street and elementary school Describe any on -site or off-site sources of light of glare e . g . parking lot lighting , or reflective materials used ) : none Describe any on -site or off-site source of odor e . g . agricultural wastes ) : none Describe any displacement of people that will be caused by the project ( e . g . numbers of people , housing units ) : none AUTHORIZATION SIGNATURES ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION . I , the Owner/Agent agree , to defend , indemnify , and hold harmless the County and its agents , officers and employees from any claim , action or proceeding against the County arising from the Owner/Agent' s project , further certify , under penalty of perjury , that I am (check one ) : [f Legal property owner ( owner includes partner , trustee , grantor , or corporate officer) of the property(s ) involved in this application , or ❑ Legal agent ( attach proof of the owner' s consent to the application of the property' s involved in this application and have been authorized to file on their behalf. , and that the foregoing application statements are true a d correct . Ernie Vasti J Print Name : Signature : Date : 7 / Z02 Print Name : Signature : Date : Print Name : Signature : Date : Print Name . Signature : Date : Print Name . Signature : Date : F :\DEVSVS\Planning Application Forms\ZONE RECLASSIFICATION Page 5 of 5 ( Rev. 05- 11 -09 )