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r. <br /> APPLICATION SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> TO BE COMPLETED BY THE APP..LICANT.PRIOR:TO FILING THE APPLICATION <br /> Owner Informatlon Applicant Information <br /> Name: ce ,+ Name: Piet,, p <br /> Address: Address: V1 u <br /> Phone: L*1C _ 7f),7_19500-3 Phone: <br /> PAOJ�GT D�SCt�1PTION <br /> Prop ..osal <br /> _ . ...... / <br /> Description of the proposed project: (r MC OF A m am LA r n C L!ji eo IA o ML-: 5 <br /> r PJ A 000 17L_00 C D C <br /> Occupant(s) - Name: ,le[-, '1(iC Age: fj '7— <br /> Name: <br /> Name: Age: <br /> Square Footage of Second Unit Dwelling: I � <br /> :['.? i�gdPttTYAN.n YtC1NITY.gSCpipYlrJN .. :; <br /> Proper►y Infarmatrori.j <br /> Assessor Parcel Number(s) Property Size Williamson Act <br /> Contract <br /> /iq ❑Yes 0 N <br /> Property Address: Q <br /> ;.....:..:... : <br /> Ex}sting Land:Uses; <br /> On-Site Uses (Include Ag Crops): I— <br /> , . : :. :: :. ... :: ROVE ICESSITS MPARS <br /> e' <br /> wat r <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water❑ Required Water (Feet) <br /> Private Water Existing Well ! New Well ❑ Well Replacement ❑ <br /> Sei?va a t)is oral <br /> :.::.::.:: 9 P <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 Other ❑ <br /> Disposal <br /> —[ <br /> toren I)rslnage::..: <br /> Public Storm Service Provider(if Public) Annex-Formation Terminal Drainage Detention- <br /> [1rJ�lnor�n r-I gPf1111fPfI in' Pn1n rIfnn Pnnr�� <br /> Private Storm On-site Retention Pond(s) ❑ Natural Drainage/No Change Other ❑ <br /> Drainage <br /> £Xatmg Fioads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> A O 1 Yes❑ No jk Yes❑ No[V <br /> T-t t'C /I/3,' <br /> Lb U`f E- ttil n 0 Q G j Yes❑ No� Yes 0 No <br />