Laserfiche WebLink
APPLICATION - ZONE RECLASSIFICATION <br /> Q. 1 <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: ZR- <br /> �4�L1 FOR?� <br /> Other <br /> Describe any items of historical or archaeological interest on-site e.g. cemeteries or structures): <br /> N/A <br /> Describe any on-site or off-site sources of noise or vibration (e.g. freeway noise, heavy equipment, etc. : <br /> N/A <br /> Describe any on-site or off-site sources of light of glare (e.g. parkinglot lighting,or reflective materials used): <br /> N/A <br /> Describe any on-site or off-site source of odor (e.g. agricultural wastes)! <br /> N/A <br /> Describe any displacement of people that will be caused by the project(e.g. numbers of people, housing units): <br /> N/A <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 from any claim, <br /> action or proceeding against 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,grantor,or corporate officer)of the property(s)involved in this <br /> application,or <br /> ❑ Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and have been <br /> authorized to file on their behalf., and that the foregoing application statements are true and correct. <br /> NL, L- C Date: <br /> Print Name: '7 Signature: <br /> Print Name: �R{��.l' �l• �� 1 r� Signature:r Date: 7� <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date. <br /> F:\DEVSVS\Planning Application Forms\ZONE RECLASSIFICATION Page 5 of 5 <br /> (Rev.04.25-05) <br />