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asp un cUra to Cann JUnnnI mmo Ml. 111 .L 11¢ - •�+ r - <br /> Y <br /> 9"Al APPLICATION - USE PERMIT <br /> SAN JOA.QUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: UP- <br /> Desakre an ilerra of historieel ora kai fineresi on-site e .cameterles�structures . <br /> There are no historical or archaeological interest on the site. <br /> Desalba an onal�or off-she wu cart d noise or Amdon� e. hsewa wise equipment.etc. . <br /> I�foiae will only be temporary during construction. <br /> Desaibe an an3ita or ort-site sources of light&clare e. .parldna lot lighting.w reflecWa materials used . <br /> ]LL arkin lot 1i <br /> htinq will be directed on-site and shielded <br /> from adjacent properties . <br /> Describe my on-site or off-site source of odor(eog.agricultural wastaa. <br /> There will be no odor from the project. <br /> Describe any clisplawmant or a that w91 be caused bv the e. .members or people,housing Lm*s): <br /> Tih.ere will be no displacement of people for this project. <br /> ty 041 <br /> YtiE t#WNWA <br /> �' i2 b 5 j x <br /> 1, the OwnerlAgent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> employees from any claim, action or proceeding against the County arising from the ON-mar/Agent's project. <br /> I,tUrther, certify under penalty of perjury that I am(check one): <br /> [a' Legal property owner(c iter includes partner,trustee,trustor, or corporate officer)of the property(s) <br /> involved ie this application,or <br /> ❑ Legal agent(attach proof of the owner`s consent to the application of the propertys 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 /> Pitnt Name: -Y-a � n Signahse: Data: <br /> Print Name; Signature: Date: <br /> Print Neme: Signature: Dade: <br /> PMt Nemo: Signature: Date: <br /> Prim Name: Signature: Date: <br /> �wefsvaci�+a.+o ppscaron Fmnsuke eeama.(fb•Ac.e aamt o) Page 5 of 9 <br />