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APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> TO 9E COMPLETED HY T"EAP.PUCANT PRIOR TO FIL'INO 7HE APPLICATION <br /> Owner Information Applicant Information <br /> Name: ( (i Name: 2D 6 r, \ %1)vzs <br /> Address: C Dv L5,- iz Address: \C,,,S5 E _ '-.15AAOt LIS WOL <br /> S' <br /> Phone: 4-pCo %k1 IF, . 7Z3 Q Phone: r�L� — ' I s— <br /> PROJECT DESCRIPTION <br /> Proposal <br /> _ .. <br /> Description of the proposed project: <br /> Occupant(s) - Name: , , �I Age: <br /> Name: \\\ ` Age: <br /> Square Footage of Second Unit Dwelling: ( (� <br /> ,{rf,„�kY:i, ..�:..;...•..$ ,V,.,y,,, {t t?HpP7Y,ANO: <br /> VICINITY.gS�CiliPY1tJN <br /> ::.................................:}. ...:::.:v;.....:.;. <br /> .:::::::.::::.�::::.�.: s• <br /> :.:::::.::::::.:�n;€”, •:;.:: :......<.:...:;:;;.:::;Pxop�irtjr tlnitibll...::.:;: ::::.:•:.:::.::::.:.::..: <br /> Assessor Parcel Number(s) Property Size Williamson Act <br /> Q s Contract <br /> ❑Yes No <br /> Property Address: (o L(7 (� (, F az �{ <br /> _ _ _ __ __ <br /> - xlstrn ;Lend UsEs <br /> 9:. <br /> On-Site Uses (Include Ag Crops): <br /> >: >'.>:>:... <br /> :> ' ITE:IMPiOVE1VIElV .S: ND SERVICES <br /> Y:::.::• <br /> ::..:....;T..:: .:.....:; :::. <br /> tNater <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water❑ Required Water (Feet) <br /> Private Water❑ Existing Well New Well ❑ Well Replacement ❑ <br /> _ .... <br /> Sawa a 01s opal. <br /> 9..:.. P. <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal❑ Required Sewer Facility <br /> F <br /> Sewage Existing Septic System ❑ New Septic System Other ❑ <br /> osal❑ <br /> .: <br /> Storm'Oralntige ..::.... .: <br /> Public Storm Service Provider (if Public) Annex-Formation Terminal Drainage Detention- <br /> r)rninnnA r'I Rnnnirnri }n• PM—fl— Pnnrf, <br /> Private Storm O"Ite Retention Pond(s) ❑ Natural Drainage/No Change ❑ Other ❑ <br /> Drainage❑ <br /> ..............;;;::::a:o:.<: <br /> 3»;:> <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> S� r Yes❑ No�` <br /> u Yes❑ No <br /> Yes 0 No 0 Yes 0 No❑ <br />