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�QvIN. APPLICATION -- SITE APPROVAL <br /> :< SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: SA- <br /> 1194 6 <br /> A- <br /> t1oINN <br /> a _ vmllO#iter. mss..:, <br /> Describe any items of historical or archaeological interest on-site(e.g.cemeteries or structures): <br /> None known <br /> Describe any on-site or off-site sources of noise or vibration(e.g.freeway noise,heavy equipment,etc.): <br /> None <br /> Describe a ny on-site or off-site sources of light of g lare(e.g.eark!n lot li htin ,or reflective materials used). <br /> Off-site lighting-NIA <br /> On-site lighting-NIA <br /> Describe any on-site or off-site source of odor(e.g.agricultural wastes); <br /> None <br /> Describe any displacement of people that will be caused by the project(e.g. numbers of people, housing units): <br /> None <br /> 4616 <br /> . ► TQFIZITE <br /> u <br /> �, O LY�f.. E�411lVNER10F, �'�1��PIOPERT�(OR��►NkAU, N-.,R�. D�►,G ��"�,1V.IAY�FIL�� PLI,G�AT ON; , <br /> 1, 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: Dino Mencarini Signature: Date: 6/5/08 <br /> Print Name: Signature: bate: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> I <br /> I <br /> R OEVSVOPlanning Application FormslSite Approval.(Revised 6.03-04) Page 5 of 9 <br /> i <br />