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APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: SD- - <br /> Al1TH0t1171CN&IGIVACt�f�f»� <br /> NI«Y YCi t�WN :Ft Q�TH ':pH f' ) tit Q(4 AN 1111 H 1H1 1 t ..Aft NT::: <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 file on their behalf., and <br /> that the foregoing application statements are true and correct. <br /> Signature: Date: <br /> Signature: Date: <br /> Signature: Date: <br /> Signature: Date: <br /> Signature: fie: <br /> AFF:U • <br /> SNL�:.:: '`;'fza<>>:: : < > <'..:`.::r':'> >#>:'`;":< :::;�`<<>>::>:`<?':.> > >:>»>: ';•.;:: <br /> E(N IiiLl $ <br /> 1. Zoning: 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❑ No❑ 3. Change Noted: ❑ <br /> 3. School District Fees ❑ <br /> 4. Fire Facility Fee ❑ PROPOSAL DENIED: ❑ <br /> 5. Flood Fringe ❑ <br /> 6. Subdivision History 3. Flood Control Conditions: 4. Remarks: <br /> 7. Remarks <br /> 4. Remarks: <br /> Date: By: Date: By: Date: By: <br /> Second Unit Dwelling Address: <br /> -3- <br />