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APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> Td BE f7MPL�TED BY7HE�kPp:UCANT;PRIORfiCSFIl1NC TH�'APPL�CAT16 <br /> Owner Information Applicant Information <br /> Name: ( Name: (��6 7 ki C,�, <br /> Address: Address: <br /> '4t_- o,. elkS' <br /> Phone: vc%) Phone: L� —1 'lot <br /> I�pOJC DirS <br /> ..........:::::.:::............::..;;..:.:.:::::.;>;: <br /> ............ . ....:..............:.:........:::.:... <br /> ::.;;:.;::;... ..:::::::::.................... <br /> } <br /> Imo. X. <br /> Description of the proposed project: <br /> Occupant(s) - Name: I r l WA� � �I I Age: 2 <br /> Name: " Age: <br /> Square Footage of Second Unit Dwelling: ( d <br /> :.;•:::;.;:<•:, X. <VIGINI :CiSC .� : laN', .. <br /> TY. <br /> :.;::.;:;::.;:;:.;:..:: :........::...... <br /> P....nY.......................::.....:::.:::. .:..:::.:: <br /> Assessor Parcel Number(s) Property Size Williamson Act <br /> — Contract <br /> i <br /> ❑Yes No <br /> Property Address: 6 C•4 7 (� (, F(z-s tj c H <br /> :..::.:::.::.:::.�::n :?w. •{{•n•: +}4}}r Y�..}. .n4,4,1n:v:• .{} :., ::. ..................... :2•� \. <br /> .... .....,:.:..�}.... xlstln i:L�rid Us6 ........................:... ..:................ . :,............. <br /> On-Site Uses (Include Ag Crops): <br /> ::;:}::::;;;:: <br /> SITE iMP CAVE E <br /> NTS.ANb:SERV:ICi»S:?:::.}.. .....:.'..:::.::.:.::..:..:.::<::.:}:{.:•>::.:.>:..:.::::' <br /> et..... <br /> .:.::::.................... <br /> ei ;:::'•ii'fiiasi:i:i ::'•i:i:i:?:fi>:ii;c;:iii::;ii.;?:•ii?'^::i ;i ??i:i:i:>'o-?:?i <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water❑ Required Water (Feet) <br /> Private Water❑ Existing Well New Well ❑ Well Replacement ❑ <br /> Sewage t7lspooaC ?< <> <`> <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 Al� Other ❑ <br /> Disposal❑ <br /> :.:::::::::::::::::.:::..:.:.:::• <br /> St <br /> :.. ..... . orm <br /> PublicStorm Service Provider(if Public) Annex-FormationII <br /> Terminal Drainage Detention- <br /> r)rnlnnnn rl Rnrniirnrl 1n• Rnfnntlnn Pnnri� <br /> Private Storm On-eke Retention Pond(s) ❑ Natural Drainage/No Change ❑ Other ❑ <br /> Drainage❑ <br /> .... <br /> ir <br /> : :. <br /> .........:... <br /> :..{.:. :.::::::::......::::...:.:,... <br /> ............ <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> R(Apil Yes❑ No PKYes❑ No <br /> Yes 0 No 0 Yes❑ No 0 <br />