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``U <br /> °P ` APPLICATION - ZONE RECLASSIFICATION <br /> >.•�,�¢t.COG <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> qP' FILE NO: ZR- <br /> Other <br /> Describe any items of historical or archaeological interest on-site(e.g.cemeteries or structures): <br /> /,A/F <br /> Describe any on-site or off-site sources of noise or vibration(e.g.freeway noise,heavy equipment,etc. : <br /> 1.r,,� r7�/Gi/nlF1 <br /> �I <br /> Describe any on-site or off-site sources of light of glare e. .parking lot lighting, or reflective materials used): <br /> Describe any on-site or off-site source of odor(e.g.agricultural wastes): <br /> \/Ef�IGGE E�nicr/cv,iJ <br /> Describe any displacement of people that will be caused by the project(e.g.numbers of people,housing units): <br /> � F <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I,the Owner/Agent agree,to defend,indemnify,and hold harmless the County and its agents,officers and employees from any claim, <br /> action or proceeding against the County arising from 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,grantor,or corporate officer)of the property(s)involved in this <br /> application, or <br /> ❑ Legal agent(attach proof of the owner's consent to the application of the property's involved in this application and have been <br /> authorized to file on their behalf.,and that the foregoing application statements are true and correct. <br /> t ✓a j f rripr/ ell <br /> Print Name: j� t^►/4-q/ Gr.P �� — Signature: #_ Date: <br /> Print Name: ✓tn v /-�� o— Signature: W` — Date: 1,--41 2 <br /> Print Name: Signature: Date: <br /> =h✓cS�✓! 9 <br /> Print Name: LLG Si, � t nature: Date: <br /> Print Name: �_ti Ale A-1 Signature: Date: (p-21.2 I <br /> AAO aN wf <br /> F:\DEVSVS\Planning Application Fonns\ZONE RECLASSIFICATION Page 5 of 5 <br /> (Rev.05-11-09) <br />