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DocuSign Envelope ID:55CF8235-1D4A-4FBA-9DD2-F1 CAB 199388E <br /> APPLICATION -- ZOIVt RECLASSIFICATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> c `P. FILE NO: ZR- <br /> Other <br /> Describe any items of historical or archaeological interest on-site (e.g.cemeteries or structures): <br /> None <br /> Describe any on-site or off-site sources of noise or vibration e. . freeway noise, heavy equipment, etc. : <br /> Project site is 3/4 of a mile from railroad tracks and 1 mile from California State Highway Route 120 <br /> Describe any on-site or off-site sources of light of glare (e.g. parkinglot lighting,or reflective materials used): <br /> None <br /> Describe any on-site or off-site source of odor(e.g. agricultural wastes): <br /> None <br /> Describe any displacement of people that will be caused by the project(e.g. numbers of people,housing units): <br /> None <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 /> further certify, under penalty of perjury,that I am (check one): <br /> ❑X 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 /> DocuSigned by: <br /> Brittany Lafferty Brr .4 5/11/2021 <br /> Print Name: Signature: _ � "� z, Date: <br /> D92FE CM DEC8492... <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: _ Date: <br /> F:\DEVSVS\Planning Application Forms\ZONE RECLASSIFICATION Page 5 of 5 <br /> (Rev.05-11-09) <br />