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ag4U'N APPLICATION - SITE APPROVAL eJ SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT P FILE NUMBER: SA- Other I Describe any items of historical or archaeological interest on-site e. .cemeteries or structures): on4e- Describe an Describe-an on-site or off-site sources of noise or vibration(e-g.freeway noise, heavy equipment, etc. : iMac NKa n i;�i p4 A.iv -I>or-lir Cov�5fde- noise ), ';c sl 4VOLKS' ibol-k o -5;1C Kei0icf On-Si-k MtckH n,'c.l Aioalf •(;�v e'Ul VV)e. wiAi +Ht Mlin4',CAVALZ 5k4p. - Describe any on-site or off-site sources of light of glare e: ,parking lot lighting, or reflective materials used): 1 6e 1 }f o -Si e- ave Will no4 /cfleJ 10 w p ap e ifef- Describe any on-site or off-site source of odor e. . agricultural wastes): one describe any displacement of people thafwill be caused by the project e. . numbers of people, housing-units): Jln AUTHORIZATION SIGNATURES ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. 1, 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 County arising-from the Owner/Agents-project. 1, 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 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. Print Name: �� /�nr 6'r Signature: Dater_ Print Name: Signature: Date: Print Name: Signature: Date: Print Name: Signature: Date: Print Name: Signature: Date: FADEVSVCTIanning Applicaton Focns\Site Approval.(Revised 02-03-10) Page 5 of 9