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'o Sit - <br /> ,a. ,oPLAN MAP AMENDMENT <br /> N; 1� SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> IF <br /> `\k � :.ata FILE NUMBER : <br /> HazArdous Matorials <br /> Describe any hazardous materials/wastes that will bo prosont on -sito , , <br /> None <br /> Other <br /> Describe any items of historical or archaeological Interest on -site (e . g . cometerios or structures ) : µ <br /> None <br /> Describe 'ahy on -site or off-site sources of noise or vibration (e . g , freeway noise , heavy equipment , etc ) ; <br /> Traffic noise from Highwa 99 and farming equipment ( seasonal ) <br /> Describe any on - site or offsite sources of light of gl >:aro ( e . g , parking lot lighting , or reflective materials used ) : <br /> Headlights from street tr#.fflc . Future on site lighting will ba directed to remain on site , <br /> Describe any on-site or off-site source . of odor ( e . g . agricultural wastes ) ; w M <br /> None <br /> Doscriba any displacement of peoplo that will be caused by tho project ( e . g . numbors of people , housing units ) : <br /> None .... <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 employees <br /> from any claim , action or proceeding against the County arising from the Owner/Agent ' s project . <br /> I , further , certify under ponalty of perjury that I am ( check on (-, ) . <br /> [X� Legal property owner ( owner includes partner , trustee , grantor , oil corporate officer } of the property( s ) involved in <br /> this application , or <br /> ( ) Legal agent (attach proof of the owner' s consent to the appimiati 1 of the pro ty's Involved in this application and <br /> W have been authorized to file on their behalf , , and that the fore n , a lic fate ents are true and correct . <br /> Print Nama ; Ah AA & l halo 5iynralura : � _ �. DatQ : . .�. � 2, 0 <br /> Print Nam , Signaturo : � .^ ..._..,_. .__._ _ ..__.._._ .. __._.. Unto : <br /> Print Namo Sign �11ure : Date ; <br /> Print Name : Signaturo : <br /> `Print Namo ; `� Siaturo� Date ; <br /> FADEVSVOPInnning Application Fortis\ Page 7 of 7 <br /> r' ian Apphcnlion llmondmonl .doc . (Itovisod Wi l .l09 <br />