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APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> MPL 7ED.:BY:7H :APP.LICAN7:PftlOfi TQ_I~ILING THE APPLICA7.I.ON:':":::>'.`:; <br /> 70 BE.r:O:..::.:E.......... .. <br /> Owner information Applicant Information <br /> � <br /> ` Name: <br /> Name: t�1' 7814 2 \ <br /> Address: LMpQjAddress: o W5 <br /> A <br /> Phone: 333_ Phone: �D 9 _ <br /> : : .: . ::. <br /> :: :: : <br /> >::;:» C <br /> ro <br /> .....;:.;:.;:.;:.;::<. :::::::::.:........::..:::.::.....::.: ::::::::::. <br /> Al <br /> Description of the proposed project: )002S W <br /> Occupant(s) - Name: MW(,,,E myw� Age: (y <br /> Name: Age: <br /> Square Footage of Second Unit Dwelling: <br /> ..................pH .p Ft1Y.ANt�......C.INLrY.gI;.S.:H.:F?..a:..N.:::::::.::::.:..::.::::>:::.>::»;>::::..:.::::::::.:.;:...:.:>;::;:...::.:.:::...;.:....::<: <br /> >i? <br /> tY <br /> oPInto at <br /> ,.. <br /> ....... .... ...........................: _ ., _ <br /> Assessor Parcel Number(s) / Pro erty Si5e Williamson Act <br /> 0_ Contract <br /> ❑Yes ❑No <br /> Property Address: f rLon <br /> 9:.............:..:.:::::.::::......:......:::::::::.:::.::::.::::::::::::::::. :::.:::::.::::::::::._::::::.::.: <br /> On-Site Uses (Include Ag Crops): P,,�ag�E 6knas <br /> : IT I ..:.:.::...................:......... ......................... . . <br /> ... ........... <br /> ;: ; . . . .. ........ .............. <br /> ... .... :. : .. .............:; :: PCVICSS.M. . . . <br /> g;:>:>;, <br /> w ter<> < >< >' « <>< «> <»><> > > >« >''»>'<»'<' <` ` ;`<>««<>> ;`; <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water❑ Required Water (Feet) <br /> Private Water❑ Existing Well New Well ❑ Well Replacement ❑ <br /> p..................................................9..::..:........:::::::; ;:.; ......... ::::::::::::::::::::::::::::..:::::::::.:::: ........................ <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 Other ❑ <br /> Disposal❑ <br /> 9.::::..:..::•::.................::.....................:....................................:....::.::::.::.::...... <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 /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No V Yes❑ No <br /> Yes 0 No 0 Yes 0 No 0 <br />