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APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO.: SD-q3 - 93 <br /> fid BE COMPLETED BY TME APPLICANT PRIOR TO 1IL1[AlG 3ntt APPOCATIG�N <br /> Owner Information Applicant Intornlrltion > <br /> Name: ,��-� �� Name: <br /> Address: S 7 � Address: <br /> CS �rL' J`Jf i U <br /> Phone: 1 O J �G ��_L���,� Phone: <br /> PTto <br /> :::... <br /> ... ................. <br /> Description of the proposed project: <br /> Occupant(s) - Name: f�iyC�1 I s' ( E AV �n/�n Age: <br /> Name: / V ,C Age: <br /> Square Footage of Second Unit Dwelling: <br /> Year Mobilehome constructed (if applicable): 7 lf=L'Y <br /> ?. <br /> 1? <br /> i <br /> RW" fttY AN0�1ttCINI?ir pip wnn .<:..: :;::' >::>'::. .»: <br /> <i> a'`e . <br /> r <br /> ottil...':....: <br /> . : :::.::...... ;::.::. :::..:: .:.:. <br /> Assessor Parcel Number(s) Property Size Williamson Act <br /> l /� Contract <br /> 01 �y A ❑Yes No <br /> Property Address: ^ 7M 7WL <br /> 12z �_,4' <br /> ;:::.::;:.: :;;: ::>;::....:.::: <br /> On-Site Uses (Include Ag Crops): <br /> y� <br /> :>::>::>::>: :>::.;:.;:;;..;.:..; ::..::.::.;.;:.;:.;; env e <br /> .::.:.::.:......::��.... .; .... ...... ........ ... .. � K �.r:.................................................................:.:..:.:::.::: <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water❑ Required Water (Feet) <br /> Private Water Existing Well New Well ❑ Well Replacement :01 <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal❑ Required Sewer Facility <br /> On-site Sewa Existing Septic System New Septic System ❑ Other ❑ <br /> Disposal <br /> Public Storm Service Provider('rf 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 /> l/ "z r_✓ Yes❑ No Yes❑ No <br /> Yes❑ No Yes❑ No <br /> -2- <br />