Laserfiche WebLink
APPLICATION --SITE APPROVAL <br />SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br />FILE NUMBER: SA - <br />Other <br />Describe any items of historical or archaeological interest on-site (e.g. cemeteries or structures): <br />Describe any on-site or off-site sources of noise or vibration e.. freeway noise, heavy equipment, etc. : <br />V4&0 lip I C19 <br />Describe any on-site or off-site sources of light of glare (e.g. parking lot lighting, or reflective materials used): <br />Describe any on-site or off-site source of odor e.. agricultural wastes): <br />Describe any displacement of people that will be caused by the project (e.g. numbers of people, housing units): <br />AUTHORIZATION SIGNATURES <br />ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN A7officers <br />I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its ageemployees from any claim, 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, trustor, or corporate officer) of theinvolved in this application, or <br />Legal agent (attach proof of the owner's consent to the application of the property's involve <br />application and have been authorized to file on their behalf., and that the foregoing application statements <br />are true and correct. <br />Print Name:'Signature: Date: (7 <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />F ZEVSVGPIanning Application Formsl.Sile Approval. (Revised 1-3-03) Page 5 of 9 <br />