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�01 N APPLICATION LITE APPROVAL y 1 SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT 1 FILE NUMBER: SA- ♦ zy OW, 1.Ci V1110r �.�2i �, Describe any items of historical or archaeological interest on-site (e.g. cemeteries or structures : t Jo r._t E K rJ 0 W rJ Describe any on-site or off-site sources of noise or vibration (e.g.freeway noise, heavy equipment, etc. : VF—t4 le LJ "2 I' IrJ�tsE FRo+-� t..tEchlAr-JiC �NoP FAt321c.�-r !0 rJ :1tS� F�.o.�t '. METAL pP. `` Describe an on-site or off-site sources of light of glare e. parkinglot lighting, or reflective materials used): A>.iT I C t P ATE ii.J'S &LLjsJ6 APPP-O %�h-rEt`( 7 S-C9CET LIG POI"TE":�) flo,.)awAZD 1/J THE— " &,T.E2+AL -rDQ66E LGb1r5 APPoxt. -hTEt_Y t$ 1-3%614 Describe any on-site or off-site source of odor(e.g. agricultural wastes): I1 , t-.t E E)XPEc T ED . Describe any displacement of people that will be caused by the project (e.g. numbers of people, housing units): IJot-tE ExPEc-rE-0 . 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): Legal property owner (owner includes partner, trustee, trustor, or corporate officer) of the property(s) Involved in this application, or ❑ Legal agent (attach proof of the owner's consent to the application of the property's involved in this application and have been authorized to file on their t�ehatf., and that the foregoing application statements are true and correct. Print Name: i�"aYkj /' ,Vft tte Signature: V2A Date: Print Name. OL&A M//�µe � Signature: Q Date (O Print Name Signature: Date: i Print Name. Signature: Date: Print Name. Signature: _ Date: F\DEVSVC%Plannmy AppLeabon Furms\Site Approval (Revised 1-3-03) Page 5 of 9