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APPLICATION SITE <br /> APPROVAL <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> �dc1-go Nva FILE NUMBER: SA- <br /> Other <br /> Describe any items of historical or archaeological interest on-site(e.g.cemeteries or structures): V)p V) <br /> Describe any on-site or off-site sources of noise or vibration (e.-q.freeway noise,heavy equipment,etc. : rl 0 v <br /> Describe any on-site or off-site sources of light of glare(e.g. parkinglot lighting, or reflective materials used): <br /> Describe anv on-site or off-site source of odor e. . agricultural wastes): <br /> �hr'cke� nno,nuc� <br /> Describe any displacement of people that will be caused by the project(e.g. numbers of people, housing units): <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <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: 8(f V er I' • Signature: . Date: 12--19-06 <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> F:IDEVSVC1Planning Application ForroslSite Approval.(Revised 13-03) Page 5 of 9 <br />