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°P0.uIN' APPLICATION - ZONE RECLASSIFICATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> =: FILE NO: ZR- <br /> ."T o Rcy <br /> Other <br /> Describe any items of historical or archaeological interest on-site e. .cemeteries or structures): <br /> NO HISTORICAL OR ARCHAEOLOGICAL INTERESTS ON SITE <br /> Describe any on-site or off-site sources of noise or vibration(e.g.freeway noise,heavy equipment,etc. : <br /> NOISE FROM INDUSTRIAL MANUFACTURING <br /> Describe any on-site or off-site sources of light of glare e. .parking lot fighting,or reflective materials used): <br /> SITE AND PARKING LOT LIGHTING ON INDIVIDUAL LOTS. ADDITIONAL STREET LIGHTING <br /> NO GLARE AFFECTING SURROUNDING PROPERTIES <br /> Describe any on-site or off-site source of odor(e.g.agricultural wastes): <br /> NONE <br /> Describe any displacement of people that will be caused by the project e. .numbers 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 /> 1,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 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,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 /> Print Name: DAVID RAJKOICH Signature: M ` �� Date: 1/30/14 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F.%DEVSVSWIanninq Apphealim FomrAZONE RECLASSIFICATION Page 5 of 5 <br /> (Rev_05-11-09) <br />