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I <br /> I <br /> APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> �'� CE]MpX T ►Y T fK q��.M NT l�ii1G T�? 'tI.11" SME AM'EIGATION . <br /> Owner Information <br /> Applicant Information I <br /> Name: IK-,t A) fk I it xcc, Name: <br /> Address: ;SC7 dl�lr►7 �r� r4 Address: (3:5S <br /> S�rJC 4CJl C14 r `] - I JL- I4d1 t�} 2� <44 C^ C�:� 53G <br /> Phone: r c' Phone: ;� i <br /> r' <br /> x:31 t 3 7'r .. <br /> Description of the proposed project: <br /> Occupant(s) - Name: [?��C S ��e p:} Age: <br /> Name: l Age: <br /> Square Footage of Second Unit Dwelling: <br /> q g g: <br /> 4$ <br /> : <br /> h M } :�:>':''':� f7t•£ ',11►1'Ifli11RllYir <br /> Assessor Parcel Number(s) Property Size Williamson Act <br /> Contract <br /> if CVC 7– J S S..i if C..12 S a Yes ❑No <br /> Property Address: <br /> Kl iii fi 9':E.1113d rU 441r <br /> On-Site Uses(Include Ag Crops): <br /> -A- fit: <br /> :>J: <br /> SITI ....MEsFMNta SND SERVS.... ... :. <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water❑ Required Water(Foot) <br /> Private Water'– Existing Well Z_ New Well ❑ Well Replacement ❑ <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal O Required Sewer Facility <br /> On-site Sewage Existing Septic System ❑ New Septic System Other ❑ <br /> Disposal-0- <br /> : ......... ►4t#n Dr#Inpge . . ..:.: ..:.... <br /> Public Storm Service Provider(if Public) Annex-Formation Terminal Drainage Detention- <br /> Drainage 0 Required to: Retention Ponds <br /> I <br /> Private Storm On-aRe Retention Pond(s) 0 Natural Drainage/No Change" -- Other ❑ <br /> Drainagoij— <br /> .1 <br /> :rrF,.;.:�..}.:Sa'F,r:c.{::•:J:.:r: S 5^itt: }:i:i �i:i �� <br /> �::,..}>'ss.:<:<e:a.�;:�s:.:}:<:•:..�. :.::�....:. ....... ;t.2�.•t.EEi�il1.F�# I <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yee❑ No Rr Yee D No F11- <br /> Yes 0 No❑ Yes❑ No 0 <br />