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APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: SD- - <br /> ;.;:;:.::.... . .. . . 11 .5 dCtA'R tlf :>s>::>::::::>:: _ <br /> UNI-Y>TH1 <.OWNE <br /> fi Q!.CIS Pf3gPmI 1yb".AKA ilel 0.d 11� bb1i�Cfl1.E NQ p>~iCA?fdC# <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 Tile 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: <br /> G <br /> S!gnnhm+: Dates <br /> Signature: DsW <br /> Signature: D <br /> Signat+ae: Data <br /> ._.._..............._............... _... ... ....... .........._.... ....._ _...... _..._..............._ <br /> a• ......... <br /> : <br /> pEVE14PfA> 1;SERYHCES ::: 'Ut3K: <br /> //''. <br /> 1. Zoning:Qy 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 W. No❑ 3. Change Noted: ❑ <br /> 3. School District Fees 5y"r-KIA- II <br /> 4, Fire Facility FeejEZ-1,4-:/t1 ❑ PROPOSAL DENIED: ❑ <br /> 5. Flood Fringe ❑ <br /> 6. Subdivisi History 3. Flood Control Conditions: 4. Remarks: <br /> 7. Remarks .r ApV__(Q�� r <br /> 7 4. Remarks: <br /> Date:�j �y By: Date: By: Date: By: <br /> Second Unit Dwelling Address: <br /> -3- <br />