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APPLICATION - ZONE RECLASSIFICATION <br />SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br />FILE NO. ZR - <br />Other <br />Describe any items of historical or archaeological interest onsite (e.g. cemeteries or structures : nothing known of <br />Describe any on-site or off-site sources of noise or vibration (e.g. freeway noise, heavy equipment, etc. : <br />E Main Street and elementary school <br />Describe any on-site or off-site sources of light of glare e.g, parkin lot lighting, or reflective materials used): none <br />Describe any on-site or aff-site source of odor (e.g. agricultural wastes): none <br />Describe any displacement of people that will be caused by the project (e.g. numbers of people, housing units): none <br />AUTHORIZATION SIGNATURES <br />ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY PILE AN APPLICATION. <br />I, the Owner/Agent agree, to derend, 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 />further certify, under penalty of perjury, that I am (check one): <br />m 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 arllfi correct. <br />Ernie Vasti <br />Print Name: Signature: > Date: <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />Print Name: Signature: Date: <br />RTEVSVMPlanning Application Forms%ZONE RECLASSIFICATION Page 5 of 5 <br />I Rev. 05-11-09) <br />