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APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> "......... '1 O..B.E Ct71GIPI.ETLICANT Pf3 OR TO FILING 7HE APPLICATION <br /> ;Owner I <br /> nfor <br /> mation Applicant Information <br /> !N <br /> Name: � Name: //��-� 01, <br /> Address: / � Address: y ! <br /> Phone: c— � O-/d� Phone: �� –3� ✓� <br /> . <br /> »ao�r:cr nscr � rcoN <br /> ::::.::: ..::::::::pro al . <br /> Description of the proposed project: �IO/djl ,I <br /> Occupant(s) - Name: /l"'IL-lam /��� Age: ��(v <br /> Name: Age: <br /> Square Footage of Second Unit Dwelling: 72567 <br /> ..... <br /> MOPEftt1�:ANO O.Nit.y. Ca pTt N.:. <br /> .... .. <br /> Pro e.r. rnfarmat. <br /> R.:tY... <br /> Assessor Parcel Number(s) / Property e Williamson Act <br /> r–� 3 1,51 Contract <br /> �yy Cl Yes No <br /> Property Address: � �� t/ <br /> Existing Land uses. <br /> On-Site Uses (Include Ag Crops): iC�✓J <br /> SITE:IMPRUUMNTS AND Si"RViCES <br /> .......... :::> <br /> ,. <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water❑ Required Water (Feet) <br /> Private Water Existing Well New Well ❑ Well Replacement ❑ <br /> >: »:> <br /> ...: <br /> ` <br /> .: . <br /> . Sewn a Qis seal : ::>::::>:` ><::>. <br /> r?;,. <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 [IDisposal <br /> Storm Drains.1:0e <br /> Public Storm Service Provider(if Public) Annex-Formation Terminal Drainage Detention- <br /> Drainage❑ Required to: Retention Ponds <br /> Private Storm On-site Retention Pond(s) ❑ Natural Drainage/No Change 1�1< Other ❑ <br /> Drainage❑ <br /> :........... <br /> ::.;;:.;;;:.;:.;:.;::.::.;:.;:.;:.;>:<.;:.;:.;:.;:.:.......X. <br /> ::::.:::.::::::::::::::::::::::::::::::::•:::::::::::::::::::::::::::::.:.Ezistrn <br /> 9.:::::::::::::::::•::::::::::::::::::::::::::::::::::::::::::.;:::::.::::.::::::::::.::::::::.::::::::.::::::...:::::::::::::::: <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> `� Yes 0 No 0 Yes 0 No 0 <br />