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Second Unit ®welling Application Form <br /> • �`+�tFo�,Y�' • SAN JOAQUIN COUNTY A <br /> COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 EAST HAZELTON AVENUE <br /> STOCKTON, CALIFORNIA 95205 <br /> TELEPHONE: ( 209 ) 468-3120 <br /> (To Be Filled Out By Applicant ) <br /> Property Agent of <br /> Owner : - Owner : ��✓!js <br /> Address : Address <br /> CityCity: I7-k/j <br /> State/Zip: 3,- tate/Zip: ac�S <br /> Phone• - _> ,ice Phone : <br /> ❑ PROPERTY INFORMATION <br /> Property Address / 78 �Z ,.S'. "" d <br /> Assessor ' s Parcel Number (s ) <br /> Parcel Size b-4 e1z <br /> Current Surrounding Land Uses : North East ; <br /> South e West <br /> ❑ OCCUPANT INFORMATION <br /> Second Unit Dwelling <br /> Occupant ( s ) : Name Age (s ) <br /> Relationship to Property Owner <br /> Proof of Infirmity or Age Must be Attached <br /> Size of Second Unit Dwelling <br /> Size of Mobilehome , � <br /> j .S� Age of Mobilehome _ <br /> Explain how the Second Unit Dwelling can be converted to another <br /> permitted use or removed when it is no longer occupied by a pers n( s ) <br /> 55 years of age or older . /,/// _ZZ, <br /> Second Unit Dwelling -3- ( 7/ 89 ) <br /> I <br />