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c° APPLICATION — QUARRY EXCAVATION s 1:. SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT �Q•.-- - .;P FILE NUMBER: QX- Surface Transportation Assistance Act(STAR)trucks Will STAA type trucks,over California Legal length,be used as part of the proposed operation? r� Yes❑ (if yes,the applicant must provide a letter requesting designation of the proposed facility as an STAA terminal.) No ❑ AUTHORIZATION SIGNATURES OWNER, OPERATOR AND APPLICANT INFORMATION AND SIGNATURES ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. Property owners or owners of surface rights list all owners Name: ';' Address: lJ �,� ! Phone. Signature: Date: Name: Address: Phone: Signature: Date: Name: Address: Phone: Signature: Date: Name: Address: Phone: Signature: Date: Name. Address: Phone: Signature: Date: =AIILegalers of the property(s) involved in this project or their legal agents must sign the application thereby tements contained in the application are true and correct. If a legal agent signs the application on y owner,written consent by the owner must accompany the application. Owners of mineral rights Name:, r.. 'ti j Address: - yap Phone: Name: AddEE ress.- z :� Phone: --... // Operator E /Ll: l i� `� Address: (�V> - - . f� -� fvl , Pho�ED Name: Address: a Phone.- Agent of process (person designated by operator as agent for the service process) Addres y F:\DEVSVC\Planning Application Forms\ Page 4 of 19 Quarry Excavation.doc.(Revised 02-03-10)