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APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 70 BE COMPLETED BY THE APP..LICANT PRIO R;70 FILING THEAPPLICATION <br /> owner.InformationApplicant Information <br /> Name: Q e—Al Name: j�l�S' 7j/ <br /> Address: Wp Address: �� UQ��a[rl GCJG�af/ <br /> ply <br /> Phone: �� 9 �' Phone: <br /> pROJ CT DESCRIP,.TI0 <br /> Description of the proposed project: <br /> Occupant(s) - Name: �G{yl�C�C� L \fi�' � Age: 7/ <br /> Name: /�t?�'L'ex �T zea w PiHA Age: TD <br /> Square Footage of Second Unit Dwelling: <br /> PROPERTY,AND VICINITY DESCIjIPTION <br /> : ;2 <:>:<: ;:;::::.:>:i:i:'i"'''.:::i�;i ii.>::.:'. <'» 'r " Or ation. <br /> Prope ty lnf m <br /> Assessor Parcel Number(s) Property Size Williamson Act <br /> Contract <br /> ❑Yes )KNo <br /> Property Address: -3O O cSt Q S <br /> E.xasUng Land Uses <br /> On-Site Uses (Include Ag Crops): f?y <br /> . <br /> ....:i4??<::'i C;i ii::;E:i•i: i?i%:i i 'o:i%i%':'S'i;ii :>:i:: <br /> SITE IMPR�VEMEN.,TS .AND SERVICES: <br /> ...........::.::... <br /> ::.. ..:.:::::.:. Water <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water❑ Required Water (Feet) <br /> Private Water Existing Well � New Well ❑ Well Replacement ❑ <br /> '•i''ii'i% '<'3.'•i'; 't'` i3;i%i .. ,:.....:: ::......:..::::.:... <br /> :: :;.:;.;>::::;;;. e s Osal :. <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal❑ Required Sewer Facility <br /> On-site Sewage Existing Septic System ❑ New Septic System I� Other ❑ <br /> Disposal❑ <br /> Storm<Draina ; <:;: <br /> 9. XW <br /> Public Storm Service Provider (i!Public) Annex-Formation Terminal Drainnae Detention- <br /> Drainage❑ Required to: Retention Ponds <br /> Private Storm On-site Retention Pond(s) ❑ Natural Drainage/No Change J' Other ❑ <br /> Drainage❑ <br /> >•:>::>:<:»::>::.;::::>::>::;<::::«::......:>r::>::::::>:::;z:::::;:>::>::>s:;;:;:<:<:::'t:::;::;:»:<:>:<:;•;?;::i»< Istlh Dad ... ........ <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No W/ Yes❑ No <br /> Yes❑ No 0 Yes 0 No 0 <br />