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: APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO.: SD-6i3 <br /> TQ RSI*:�C9MF!1p: A P CI <br /> R 1.;.:.Fa1 C'R 4R TQ i»14114r #� APi'I I ATIQK <br /> A <br /> Owner Information Applicant Information <br /> Name: Name: <br /> Address: /1-,\/) Address: <br /> Phone: Phone: i f /- 1 ,7Y-1 <br /> ECTD <br /> >;:::;: . <br /> Description of the proposed project: l ,] <br /> Occupant(s) Name: Q '� ((•� �'t _) k Age: G <br /> 7 <br /> Name: Age: <br /> Square Footage of Second Unit Dwelling: v <br /> Year Mobilehome constructed (if applicable): S <br /> .............. ffl <br /> ::....::....................................................................... <br /> ......i:::'++?.:%'.: }•::.•i:•::i:!,.; .:':ii::i::iN'::n;`.•r.;;•:r .. h: <br /> i:;;:(:i::::'::ikv:i:•:•iiiiii:J::i':r`::i::::':::iii:i:.. . <br /> OfMAR <br /> PIP <br /> Assessor Parcel Number(s) Property Size Williamson Act <br /> Contract <br /> 7 ❑Yes El�o <br /> Property Address: 3 (. K <br /> FJtt�4f!!1q LHd ::: <br /> On-Site Uses (Include Ag Crops): <br /> .:.: ::; <br /> M. <br /> waist.;: :: >`; <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water❑ Required Water (Feet) <br /> Private Water❑ Existing Well Ipl"/ New Well ❑ Well Replacement ❑ <br /> >... .. <br /> "!+! PE <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal❑ Required Sewer Facility <br /> On-site Sewage Existing Septic System ❑ Now Septic System Other ❑ <br /> Disposal ❑ <br /> . .. . .. <br /> :E::: :?i;::'<'' 3torta,EN�Ra li:; ` :':E:::.`'''; <br /> ::. :.. <br /> Public Storm Service Provider(if Public) Annex-Formation Terminal Drainage Detention- <br /> Drainage❑ Required to: Retention Ponds <br /> Private Storm On-site Retention Pond(a) ❑ Natural Drainage/No Change ❑ Other ❑ <br /> Drainage❑ <br /> :.:.......:;:. ::.::::::::...... p Ronda <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> -2- <br />