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---------- - <br /> 1 <br /> APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> >::3Lat: :aC Wtl . TToWHO. <br /> ;.. ....:.:::::. TSE.APP4tW .:::::....:.::: .:::::::::::.:::.:.:.::::::.: <br /> Owr�ar:k►fonnation <br /> App]cant Iniormatlort <br /> '/ <br /> Name: /C�� pi 1 k)'- Tl s Name: <br /> Address: Address: <br /> Phone:j(q`_7 �� 3 p k Phone: <br /> ...................................... ... <br /> .................... <br /> Description of the proposed project: d _G C"7 oc, fl <br /> Occupant(s) - Name: /�� /�C��„f Age: �0 9•. <br /> Name: / Age: <br /> Square Footage of Second Unit Dwelling: 6 <br /> ... ............. . <br /> :::::::::::::::::::::.::..::::..::::.::.::::::::::::::::::::::::............. .... YK`fly.f3 5�.t11x.IG......;;.;:::.:;:.:::.;:.;:;.;:.;:.;,:.;:.;..::::.::.::::::.:::.:.:..:.:...:.:..:.:::..:::::::.::. <br /> ... ................ <br /> Assessor Parcel Number(s) Property Sae Williamson Act <br /> Contract <br /> 155- o� — ❑Yea ❑No <br /> Property Address: ( ( 51 �fo, p . LOD I <br /> X. <br /> Onsite Uses (Include Ag Crops): <br /> .......::.;:.::.;.::;:.;::.;:.;:.::.::;::.;: :::.;:.::.;:.;:.;:.;:..:. <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water❑ Required Water (Feet) <br /> Private Water❑ Existing Well New Well ❑ Well ReplacemXX <br /> ent ❑ <br /> ::. <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal❑ Required Sewer Facility <br /> On-site Sewage Existing Septic System PIK New Septic System ❑ Other ❑ <br /> Disposal❑ <br /> ; ::::;:z:::> ......................:L3f81tf.�.yy <br /> .. ..........................._.........:.::.......�'7/.":>:>.;;:.;:::..<;;>;;;:;: ::::;,;»:<::;;;:<::>::::f;:Y: ;::»::<,.;: <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 Other ❑ <br /> Drainage❑ <br /> dirt terra :: :.: .. <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> 9Yes❑ No Yea❑ No <br /> Yes❑ No❑ Yes❑ No❑ <br /> -2- <br />