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`Mf <br /> r _cA� Second Unit Dwelling Application Form <br /> I; *�`�. SAN JOAQUIN COUNTY Part A <br /> COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 EAST HAZELTON AVENUE <br /> STOCKTON, CALIFORNIA 95205 <br /> TELEPHONE: (209 ) 468-3120 <br /> (To Be Filled Out By Applicant ) <br /> Property Agent of <br /> Owner . owner : MeOtA o 1- <br /> Address : W ,+-i- L-PJ Address : 195 yo 51 Y. tT' cy� <br /> City : StoCk+ov` City: t6 r 44 <br /> State/Zip: Cq5-P Is State/Zip: jfA q 5.3 L <br /> Phone : Phone: 'Aa 3- 1-) C,-!s <br /> ❑ PROPERTY INFORMATION <br /> Property Address <br /> Assessor ' s Parcel Number (s ) <br /> Parcel Size s, O S 6 C-9,nL S <br /> Current Surrounding Land Uses: North ijc� East �tO Q�u� �cAw, t.1fi <br /> South -1West <br /> ❑ OCCUPANT INFORMATION <br /> Second Unit Dwelling /� <br /> Occupant (s ) : Name 4-v1p'-,V A, Age (s ) �3 <br /> Relationship to Property Owner Mom i <br /> Proof of Infirmity or Age Must be Attached <br /> Size of Second Unit Dwelling <br /> Size of Mobilehome 1y)(L,(D X79 Age of Mobilehome OT-L.0 <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 age or older . _� c-A �z no <br /> ryL�- <br /> Second Unit Dwelling -3- ( 7/89 ) <br />