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APPLICATION - ZONE RECLASSIFICATION <br /> ; ► .ate <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO. ZR- <br /> \ Fly 1 <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 arllft 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 />