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pUr" APPLICATION -z-SITE APPROVAL <br /> < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: SA- <br /> [/FORt+ <br /> dtKe <br /> Describe any items of historical or archaeological interest on-site e. .cemeteries or structures): <br /> Describe any on-site or off-site sources of noise or vibration(e.g.freeway noise,heavy equipment,etc. : <br /> AlwyC- <br /> Describe any on-site or off-site sources of light of glare (e.g. parkinglot lighting,or reflective materials used): <br /> We- t Y qU l,. V L t b W-75 <br /> Describe any on-site or off-site source of odor e. .agricultural wastes): <br /> N tC' <br /> Describe any dis lacement of people that will be caused by the project e. . numbers of people, housing units): <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 <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, trustor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> Legal agent (attach proof of the owner's consent to the application of the property's involved in this <br /> application and have been authorized to file on their behalf., and that the foregoing application statements <br /> are true and correct. <br /> Print Name: M fT t 1 Signature: Date: 0� <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FIDEVSVC\Planning Application Farms\Site Approval.(Revised 1-M3) Page 5 of 9 <br />