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L: <br /> APPLICATION — S--;E APPROVAL . <br /> roc <br /> ' SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 00 <br /> FILE NO: SA- <br /> Other <br /> Describe any items of historical or archaeological interest on-site(e.g.cemeteries or structures): <br /> None known <br /> Describe any on-site or off-site sources of noise or vibration (e.g.freeway noise, heavy equipment, etc.): <br /> None on-site <br /> Union Pacific Rail Road M'West <br /> Describe any on-site or off-site sources of light of glare(e.g. parking lot lighting, or reflective materials used): <br /> None <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.g. 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 <br /> employees 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, grantor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> Lt�rintName <br /> gal agent (attach proof of the owner's consent to the application of the property's involved in this <br /> plication and have been authorized to file on their behalf., and that the foregoing application <br /> atements are true and correct. <br /> Gurmeet Kaur Signature: Date: l 'o. <br /> PrintBalieet Kaur Signature: _ Date: !4_1 <br /> Print Jay Khalsa Signature: Date' f- C'•�'- <br /> Signature: Date: <br /> Signature: Date: <br /> F 0EVSVSWlann1ng Application Forms\Site Approval(Revised"3-04) Page 4 of 4 2007-58 SA(2).doc <br />