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PLAN MAP AMENDMENT <br /> ^ SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> -ra FILE NUMBER: - - <br /> Describe any hazardous materials/wastes.that willbe present on-sites <br /> NONE <br /> Describe any items of historical or archaeological interest on-site(e.g.cemeteriesor structures):. <br /> NONE <br /> Describe any on-site or off-site sources of noise or vibration.(e.g-freeway noise,heavy equipment,.etc.): <br /> TRAFFIC NOISE FROM CALIFORNIA STATE ROUTES 132 AND 33 <br /> Describe any on-site or off-site sourcesof light of glare(e.g..parking lot lighting,.or reflective materials used):.. <br /> MINIMAL OFF-SITE GLARE <br /> Describe any on-siteor 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.g..numbersof people,housing units): <br /> MINIMAL <br /> 71r,theOwner/Agent agree, to defend, indemnify, and hold hannless the County and its agents, officers and employees <br /> , action or proceeding against the Owner/Agent's project. <br /> fy 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 <br /> this application, or <br /> ❑ Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and <br /> have been ai4thoriZed tqfile on their behalf., and that the foregoing application statements are true and correct. <br /> Print Nam Signature's Date:AO—A —05— <br /> Print Nam Signatur Datey;o5 —QS <br /> Print Name: Signatur Date: <br /> Print Name: Signature: Date: <br /> Print Name: .. Signature: Date: <br /> FftDEvsvctPlsnning Application Formst Page 7 of 7 <br /> Plan Application Amendmentc1m.(Revised 06-03-05) <br />