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a <br /> APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO.: SD- - <br /> :: <br /> :.;:. <br /> lO BE;COM!3I E Cx:6t i l► P)I CA �`>PFti! TV> I l N A�'tj".::;:.::...:... >:.. ...' >r`:: <br /> Owner Information I 11Appl(canfI. Information <br /> Name: OB IST C T Name: _,J I /t//% , M A C /1/A O H- <br /> Address: ' I Address:(_0( g/ M D LSC( t"'D , <br /> S OC K7d-yN L'/I o`L/5' S�C(c-z�M CA qsa I,S <br /> Phone: g' -S � )9 9 Phone: o`Z09-S �_& ,SZ, �'Ae 8'F&-_537V <br /> ;:.:;:.::::::::::::::::............................................... :;:::::.::.::..:::.:::::.:::::::..::......................:.:...::::::::::::.::::::::::. :..: <br /> ;: .......::::.:::::..........;::::::::::::.;;;:;.. <br /> :::.::..::::::.::::.::::::::::::::::::::::::::-...::::.::::::::::::::.::::::::::::::::::::::::::.::: <br /> .:::::::::.::::.::::::::::::::::::::::::::::::::::::::.:::::::::.::.::::::::::::::::::::::::.:::: <br /> Description of the proposed project: /w '3 i 4_6— /T e/",!,-- <br /> Occupant(s) - Name: R 0 6L-,2T D M/4G NA t/6 H <br /> Age: S 3 <br /> Name:S UR N I 1 A ,M .. MAC /ll't(_ l P 7_ Age: ,.5-,/ <br /> Square Footage of Second Unit Dwelling: � I 'Z�C /' L i\/;h YPr. <br /> Year Mobilehome constructed (if applicable): / q 9 y <br /> ..:::::::..:.:..::....:::.:.... {.,,...,:.:::::::::::::.:.:::.::::....:....:.... .... ... <br /> "Ft{t 1 ANR< 'i ![I :;q i'FIt N;.::.:::::;::;;:;.;;;::::;»><:>;:::::;;r::::: .:<:.:...,::::.,".r:;:::.;::>::::;::::::: <br /> .... <br /> :a :u : :: . : : ;PH ::::::::> : :> . .. . <br /> .> <br /> . ....... ;. . . . <br /> Assessor Parcel Number(s) - Property Size Williamson Act <br /> Contract <br /> 0- (- l y, 5 8 /-} c x?C- (Yes ❑No <br /> Property Address: 6 1 9 I M0 0 C&Zf fe-Q S`ZCG/���/ (!ZA `'S-o'L /S <br /> ..:::..,>: >: <br /> >::tlfd>:.;..:: <br /> ..is>; <br /> On-Site Uses (Include Ag Crops): A f«/vT,5 <br /> ::.::.>:::.:::::::::: :,..: :::::...::::;:;.::: ::.;:...:.:::..:. <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water❑ Required Water (Feet) <br /> Private Water Dd Existing Well New Well ❑ Well Replacement ❑ <br /> >:'::— :----;:.;:.: .::::::.`.::.::::: »::;;:...:<`:::;'`';::.::;:;.;.:::;'s`: »:::;::;:>s::;::;>::>:.;:.>::.; .'::... ..:.::..;:.:.;:.;:.;::.:.::..;.: .:... ::.:.::: <br /> . . .. .................................. . . <br /> :::; <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal❑ Required Sewer Facility <br /> On-site Sewage I Existing Septic System ❑ New Septic System ,W Other ❑ <br /> 11 Disposal <br /> > �1(tiic :a�attln <br /> ::.:... <br /> q ..: .:::... : <br /> wwwwww. <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(s) ❑ Natural Drainage/No Change 2� Other ❑ <br /> Drainage❑ <br /> :.. <br /> :1 <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> M O r6L&- 20 , Yes❑ No❑ Yes❑ No 3 <br /> Yes❑ No❑ Yes❑ No❑ <br /> -2- <br />