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t <br /> ..�� <br /> APPLICATION - ZONE RECLASSIFICATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: ZR- <br /> �9,{'+FORT/ <br /> Other <br /> Describe anv items of historical or archaeological interest on-site(e.g.cemeteries or structures): None <br /> Describe any on-site or off-site sources of noise or vibration(e.g.freeway noise,heavy eauioment.etc.): The Property is <br /> near Highway 4 and Escalon Bellota Road. <br /> i <br /> Describe arty on-site or off-site sources of light of glare(e.g.oarking lot lighting,or reflective materials used): On site <br /> lighting (low glare fixtures) <br /> Describe any on-site or off-site source of odor(e.g.agricultural wastes): None <br /> i <br /> I <br /> Describe any displacement of peocle that will be caused by the oro'ect(e.g.numbers of oeoale,housing units): None <br /> l • <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORQED AGENT MAY FILE AW 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 application, <br /> 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: ,Signature: — Date: , <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> ' Print Name: Signature: Date: <br /> k <br /> N <br /> t <br /> FA0EVSVS%PIan6ngApp1ica:icn Fonns=NJ=RECLASSIFICATION Page 5 of 5 <br /> (Rev.5-02.44) <br />