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Q,��.�P APPLICATION - ZONE RECLASSIFICATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: ZR- <br /> i - <br /> Describe an Rama of historic or archaeold ices Interest an-alta a malarles or structures <br /> None <br /> Desarlbe an on-alta or otf-site sources of noise or vibration a. .freewa noise has a ul menl etc. <br /> Nona <br /> Describe an on-alta or off-site sources of 11 ht of tare e. ricin lot II hUn or reflective ma[erfals usatl <br /> Non <br /> Describe an on-slte�or off-sits aoUrae of odor e. rlculturel wastes <br /> Nona <br /> �Desorlba an rile lacement of eo le that will be caused b the ro ecC e- .numbers of eo le housi units <br /> None <br /> ::.:7l.VTry�l.R Y... Rt�lota.g'rytRYz.�� .�� <br /> _ .;... <br /> P.Nj-.Y T!'iIa`..OLJN6R;�UF:TWE BAS �P.HT '2S. .:� N/.jIClTHt�.RI P �A4'I�NY'MAY';FIi,.E AN IkPYLiCA'C1,4.N ...[ <br /> 1.the Owner/A9ant a9raa,to defend,indemnify,and hcldhennlasa the County and Its s9enla.oHicera antl employees£rom any claim, <br /> eatlon or proceeding against the County arising from the OwnerlAganl's projeot. <br /> 1 further certify,under penally of perjury,that I am(check ons): <br /> Legal Properly owner(owner includes partner.trustee,grantor,or corporate ofFlceq ofi Iha property(s)Involved In this <br /> eppllcatlon,or <br /> Q legal agent(attach proof of[he owner's consent to the application of[ha property's Involved in this appiicailon and have bean <br /> authorized to file on their bahelL,and that th`efor9goln9_eppllcaUon statements are true and correct. <br /> Print Nama: _� �*�"4r�T S19nature:. Data: ��'-Z� <br /> Print Nama: ®toC �--�.• �,-�-s� uG Signature: - Date: <br /> Pdni Name: /l'T�r m . .as.L�Si9nature. Data: <br /> Print Name• Signature: Data: <br /> Pdn[Name: Signature: Date: <br /> FIDEVSVSVIenning gpplleaYon ForTe)ZONE pECLh8a1FICgTION Paga 5 of 6 <br /> (qev,Ofi94aH) <br />