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°p4U`" ° APPLICATION - ZONA-RECLASSIFICATION z: z N: < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT '`�� FILE NO: ZR- Other Describe any items of historical or archaeological interest on-site(e.g.cemeteries or structures): A14217� Describe any on-site or off-site sources of noise or vibration(e.g.freeway noise heavy equipment,etc. : U,0� el Describe any on-site or off-site sources of light of glare(e.g.parkinglot lighting, or reflective materials used): Describe any on-site or off-site source of odor(e.g. agricultural wastes): Describe any displacement of people that will be ca sed by the project e. . numbers of people, housing units): zltl&-�ele, AUTHORIZATION SIGNATURES ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. I,the Owner/Agent agree,to defend, indemnify, and hold harmless the County and its agents, officers and employees from any claim, action or proceeding against the Owner/Agent's project. I further certify, under penalty of perjury, that I am(check one): M Legal property owner(owner includes partner,trustee,grantor, or corporate officer)of the property(s)involved in this / application,or ❑ Legal agent(attach proof of the owners consent to the application of the property's involved in this application and have been authorized to file on their behalf., and that the foregoing application statements are true and correct. �7 6 `f �[ `o g�i5 0 / Print Name: 0 eV � � Signatuulc Yt Date: Print Name: Signature: Date: Print Name: Signature: Date: Print Name: Signature: Date: Print Name: Signature: Date: FA)EVSVSIPIanning Apphi Uon For s12ONE RECLASSIFICATION Page 5 of 5 (Rev.12-07-06)