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APPLICATION - SECOND UNIT DWELLING
<br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
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<br /> Ownw'kMortBation ApplidM kdormatiorr i'
<br /> Name: C Name: ()"-c n,l
<br /> Address: Address:
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<br /> Phone: Phone: q LZ
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<br /> Description of the proposed project: >
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<br /> Occupant(s) - Name: C\O 'a r�PSo cv Age: 7-
<br /> Name: Age:
<br /> Square Footage of Second Unit Dwelling: ID73
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<br /> Assessor Parcel Number(s) Properly Sae Williamson Act
<br /> Contract
<br /> ❑Yes ❑No
<br /> Property Address: 7 Lk,5 TQC }
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<br /> Onsite Uses(Include Ag Crops):
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<br /> Service Provider Annex-Formation Distance to Public
<br /> Public Water❑ Required Water(Feet)
<br /> Private Water,O_ Existing Well §L New Well ❑ Well Replacement ❑
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<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 rk, Other ❑
<br /> Disposal
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<br /> Public Storm Service Provider(if Public) Annex-Formation Terminal Drainage Detention-
<br /> Drainage❑ Required to: Retention Ponds
<br /> Private Stone On-site Retention Pond(a) ❑ Natural Drainage/No Change dJ_ Other ❑
<br /> Dralnage.,B-
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<br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks
<br /> \ \ 90 , Yes❑ No 53� Yes❑ No
<br /> Yes❑ No❑ Yes❑ No❑
<br /> -2-
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