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APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> Tiy BE CpINPLETED 6Y THE APPLICANT Pfi[OR TO FILING THE APPLICATION <br /> Owner,Information Applicant Information <br /> Name: <br /> Name: _ <br /> — <br /> E <br /> Address: ��^ Address: — le-7- <br /> Phone: Phone: ->209 _ 76 <br /> 'JCC D SC. IP ION <br /> IFiO .....CT:D <br /> :....................::::.;:.;:.;.:: .... <br /> I'�aposal..; <br /> Description of the proposed project: S ccol J,fi Vlvl'T xDiuclhvc, <br /> Occupant(s) - Name: Age: 3:2- <br /> Name: (!h 1,571)YT c Le V Age: (J <br /> Square Footage of Second Unit Dwelling: An U X I Soo <br /> ...: <br /> . C3d qECp1_ <br /> NTIQN..... . . . ............ . <br /> .....:...... Pro er` .Intoe atio ;>.:>: >:<::<:::;::;:;:; »:;::;::: <br /> .. :. .. IY fn:. n <br /> Assessor Parcel Number(s) Property Size Williamson Act <br /> -_L1 Contract <br /> ❑Yes P11110 <br /> Property Address: (R551 l l E <br /> .. <br /> Exrsti�ig Land Uses <br /> On-Siie Uses (Include Ag Crops): Y" <br /> —� <br /> L <br /> IMPROVEMENTS F►ND SERV'ICE� ' <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water❑ Required Water (Feet) <br /> Private Water Lit Existing Well 191-- New Well ❑ Well Replacement ❑ <br /> p <br /> Public Sewage Service Provider Annex-Formation Distanc•>to Public <br /> Disposal❑ Required Sewer Facility <br /> On-site Sewage Existing Septic system ❑ New Septic System 0'-- Other ❑ <br /> Disposal Qs� <br /> :.::::::::::::<..::.:: ......:.::::: "Storm'Drtafnae . <br /> ...:::::>::>:::::>::;::>:::::.....:.::;::::>::>::>:. <br /> Pu')lic 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 /> :::::::::::::.::.. ::.:.:::::::::::::::..: ....:::.::.:...::::<::;.;. <br /> ............................ ....................................................................... <br /> :::::::<:>::;::::>:.;:.>«:»::::»::::>:::;:::>::::>::::>::::>?:::>:>>:;>:>::::::>::::>::::>::::::>::>:>•:>::::::::>::::>::::>::::>::::>::Ekisfin Rod ..... <br /> ::::::::::::::•::..::::::::::::::::::::::.:::::::::::::::::::::. . 9...... <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> CAS T 0 L,� U Yes❑ No&,--" Yes❑ No P-' <br /> Yes❑ No 0 Yes 0 No❑ <br />