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APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: SD- - <br /> #1173tliX�lClO?� tfltACt7Ii ::<<' :;:'.`:......... ..:.:::;... :. <br /> .. <br /> 4NkY TlfE OWN�ft Ql�:'HE P0.M.- ?B AN.AV...4fil�i?A(>�N1`11�Y3�l��INR�AP3�J.1CA'170H .....::... ....... . .; <br /> SIGNATURE: I certify under penalty of perjury that I am (check one): <br /> Legal property owner (owner includes partner,trustee,trustor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> ❑ Legal agent (attach proof of the owner's consent to the application of the property's Involved In this <br /> application and have been authorized to file on their behalf., and <br /> that the foregoing application statements are true and correct <br /> SIGNATURE: I certify by my signature that I have read and understand the Second Unit Dwelling Standards: <br /> Signature: Date: Q G I3 <br /> Signature: L Ic7 Data L <br /> Signature: DS&K <br /> Signature: Data: <br /> Sfgnat re: Data <br /> STl4 klS�btr1 <br /> pEYOItMY>G.SiiV10E5 Y'1111C11V <br /> 1. Zoning: PROPOSAL APPROVED SUBJECT TO: PROPOSAL APPROVED SUBJECT TO: ❑ <br /> 2. Project meets zoning requirements 1. Encroachment Permit ❑ 1. Sanitation Permit ❑ <br /> for both use and construction: 2. Traffic Mitigation Fees: 2. Well/pump Permit ❑ <br /> Yes❑ No❑ 3. Change Noted: ❑ <br /> 3. School District Fees ❑ <br /> 4. Fire Facility Fee ❑ PROPOSAL DENIED: ❑ <br /> 5. Flood Fringe ❑ <br /> 6. Subdivision History 3. Flood Control Conditions: 4. Remarks: <br /> 7. Remarks <br /> 4. Remarks: <br /> Date: By: Date: By: Date: By: <br /> Second Unit Dwelling Address: <br /> -3- <br />