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APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: SD- - <br /> +pttC�1'I'fON :`.:'.'MAYE:LyWOF-T EWMO MAi9AN# <br /> SIGNATURE: I certify under penalty of perjury that I am (check one): <br /> Legal property owner(owner Includes partner,trustee,trustor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> ❑ Legal agent (attach proof of the owner's consent to the application of the property's Involved In this <br /> application and have been authorized to file on their behalf., and <br /> that the foregoing application statements are true and correct <br /> SIGNATURE: I certify by my signature that I have read and understand the Second Unit Dwelling Standards: <br /> Signature: Q n - (� t f Date: )r <br /> Signature: DOW <br /> Signadire: DO <br /> Signadre: Da I <br /> Signature: Da2w <br /> :.:.::....::.:...:.....:.... :.;>;> ;:; <br /> :::.:.::::::::.::::::.:::.::.:::.:; .....::::r:::;t: <br /> _. <br /> 1. Zoning: — PROPOSAL APPROVED SUBJECT TO: PROPOSAL APPROVED SUBJECT TO: ❑ <br /> 2. Project meets zoning requirements 1. Encroachment Permit ❑ 1. Sanitation Permit ❑ <br /> for both use and construction: 2. Traffic Mitigation Fees: 2. Well/pump Permit ❑ <br /> Yes D(, No❑ 3. Change Noted: ❑ <br /> 3. School District Fees ❑ <br /> 4. Fire Facility Fee ❑ PROPOSAL DENIED: ❑ <br /> 5. Flood Fringe ❑ <br /> 6. Subdivision History S 7 3Z 3. Flood Control Conditions: 4. Remarks: <br /> 7. Remarks kq"r AM9 SASfZ_A_ <br /> TU 020. ►?�cQUi2cMay� <br /> 4. Remarks: <br /> Date: �} a3 By: Date: By: Date: By: <br /> Second UnA Dwelling Address: (y z{ i-nc vj -_ r&JAI7 Li N LY, <br /> -3- <br />