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APPLICATION - AGRICULTURAL PRESERVE <br /> iN: C SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: PA- <br /> Other <br /> Describe any items of historical or archaeological interest on-site (e.g. cemeteries or structures): <br /> NONE <br /> Describe any on-site or off-site sources of noise or vibration (e.g. freeway noise, heavy equipment, etc.): <br /> NONE <br /> Describe any on-site or off-site sources of light of glare (e.g. parkinglot 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 /> Fscribe any displacement of people that will be caused by the project(e.g. numbers of people, housing units): <br /> NONE <br /> 1-- <br /> 11 <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees <br /> 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 /> Xp 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 authorized to file on their behalf., and that the foregoing application statements are true and correct. <br /> rrintNameR&R SCHATZ PROPERTIES, AWture: Date: <br /> RODNEY SCHATZ Signature: Date: JO1(� �RAETTA SCHATZ Signature: Date: V 13 Signature: Date: <br /> Print Name: Signature: Date: <br /> F\DEVSVc\Planning Application Forms\Agricultural Preserve.doc. <br /> (Revised 09-21-06) <br />