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L <br /> Dwelling Application Form <br /> ��''�► ��� SAN JOAQUIN COUNTY Part A <br /> COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 EAST HAZELTON AVENUE <br /> STOCKTON, CAI:IFOR*ITA 952n5 <br /> TELEPHONE: (209 ) 468-3120 <br /> (To Be Filled Out By Applicant ) <br /> PropertyT Agent of <br /> Owner : A M e /r �iv V Owner : <br /> Address : Address : <br /> City: 6 c ti City: <br /> State/Zip: State/Zip: <br /> Phone: 2 oq qW7 Z 2 Phone : <br /> � v <br /> ❑ PROPERTY INFORMATION / <br /> Property Address /2 /V P,4 �7 0 /Y 14 V -C- <br /> Assessor ' s Parcel Number (s ) <br /> Parcel Size 0 �2-- A G r c-S <br /> Current Surrounding Land Uses : North&e,5J' en, East Ae-,C,�df A, p <br /> South R,,.�,1 p A,_tl�j west <br /> ❑ OCCUPANT INFORMATION <br /> Second Unit Dwelling <br /> � �� / <br /> Occupant(s ) : Name �=/ i 0Y / k A M S Age(s ) <br /> Relationship to Property Owner-4e r - i/v -1A 4- <br /> Proof of Infirmity or Age Must be Attached <br /> Size of Second Unit Dwelling ►.�/ 1// �wo � e��dvYt Afo�i��id� c. <br /> %,v Ne- xf i-C MDA10 )t-L-1 w^NFr-4 -7'b / e peroe4i µw c Se/0-41c tydfc.r: <br /> Size of Mobilehome _ Kge of Mobilehome _ <br /> Explain how the Second Unit Dwelling can be converted to another <br /> permitted use or removed when it is no longer occupied by a person( s ) <br /> 55 years of ageZ older . JA-tN_ Nc) No r�� <br /> P � <br /> Second Unit Dwelling -3- ( 7/89 ) <br />