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APPLICATION - SITE APPROVAL <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> A <br /> _ P FILE NUMBER: SA- <br /> C(p OR� <br /> Other <br /> R <br /> an items of historical or archaeolo ical interest on-site e. .cemeteries or structures : <br /> an on-site or off-site sources of noise or vibration e. .freewa noise, hea a ui ment, etc. : <br /> &railroad trackse an on-site or off-site sources of li ht of lave e. . arkin lot li htin , or reflective materials usedlot lightinge an on-site or off-site source of odor e. . a ricultural wastes : <br /> aste water,pomace from pressed grapes will be stored for a short time on property&spread on site for soil amendment. <br /> e an dis lacement of eo le that will be caused by the project(e.g. numbers of people,housing units): <br /> None <br /> AUTHORIZATION SIGNATURES <br /> Firt <br /> THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> wner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> ees from any claim, action or proceeding against the County arising from the Owner/Agent's project. <br /> ZLegal <br /> er, certify under penalty of perjury that I am (check one): <br /> property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> olved in this application, or <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 statements <br /> true and correct.e: �YLYr F fMN21 k:: Signature: Date:me: Signature: Date: <br /> me: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:\DEVSVC\Planning Application Forms\Site Approval.(Revised 02-03-10) Page 5 of 9 <br />