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APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO.: SD-93 - <br /> TO BE COMPLETED BY THE:APPLICAt+7TFRIORTO FfUrit3.THE FICA ':`<>"z'"::>.;;«:r:r,.;::.•.>«::.....I;.:< <br /> Owner Information Applicant Information <br /> Name: fA LIC Name: <br /> Address: I�� J l�-f� c L1. Address: <br /> iL'LIci?, CA Qj_jIZ <br /> Phone: _ Phone: <br /> lir' <br /> Description of the proposed project: M6PjLr= , >_ CAZe <br /> 12 <br /> Occupant(s) - Name: t L 11 s t Age: <br /> Name: Age: <br /> Square Footage of Second Unit Dwelling: / L, <br /> Year Mobilehome constructed ('rf applicable): r q ------------ <br /> c�Z <br /> OP N : iTIE C <br /> RtP <br /> PH TY <br /> Prolomsi�tiot►:>:>:: >:<::<:»:.?::>::;::>::>s::>::<:>?:<<>::::;:<sz::::r::::::i::::<'^i:•;s<•ss';'. <br /> P . l! <br /> Assessor Parcel Number(s) Property Size Williamson Act <br /> Contract <br /> ❑Yes jA N0 <br /> Property Address: l C LU -, Q <br /> . ; .............. . <br /> i ...: 2;;:` i:i:`<< i3i'iS' ;:>`:C< '%Ci i'•:y ;i;:;t;'; i;: <br /> -:. <br /> On-Site Uses (Include Ag Crops): <br /> _. <br /> :..:.......... . ......... <br /> .............. . . ............. .... <br /> SIT <br /> MP M N S'ANC�..SI= S':::<< `...... >`. ,..::;`;.>> } <`: <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water Cl Required Water (Feet) <br /> Private Water1ffi Existing Well New Well ❑ Well Replacement ❑ <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal❑ Required Sewer Facility <br /> On-site Sew a Existing Septic System-0. New Septic System ❑ Other ❑ <br /> Disposal <br /> ... tb Drtalessgs. ...:. <br /> Public Storm Service Provider(if Public) Annex-Formation Terminal Drainage Detention- <br /> Drainage❑ Required to: Retention Ponds <br /> Private Storm On-site Retenfion Pond(s) ❑ Natural Drainage/No Change M Other ❑ <br /> Drainage la <br /> ... :::::::.. <br /> :: ..:....: <br /> Extet. ::: <br /> inp Bttnei� : :::> >:::•>x: :c:'.X <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> r' Ito Yes❑ No M Yes❑ NoAr <br /> Yes❑ No❑ Yes❑ No❑ <br /> -2- <br />