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APPLICATION - SECOND UNIT DWELLING <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMEN 1 DEPARTMENT <br /> T <br /> FILE NUMBER: SD- - <br /> AUTHOR17ATION SIGNATURES <br /> aNL;Y TH;~OWNER'oF`AE PROPEHTY OR AN AUTHO�Ei�AGENT MAY ILEA1Jp app1iCACtoN <br /> SIGNATURE:: I certify under penalty of perjury that I am (check one): <br /> CK Legal property owner(owner includes partner,trustee,trustor, or corporate officer) of the property(s) <br /> / involved in this application, or <br /> 0" 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: (� ►.gyp t��o Date: oL <br /> Signature: Date: Z 79 <br /> Signature: Date: / <br /> Signa-hire: Dale: <br /> Signature: Date: <br /> STAFF USE ONLY �- <br /> DEVELOPMENT SERVICES PUBLIC WORKS ENYfROl1?AENTAL?iEALTN <br /> 1. Zoning: P` / �� PROPOSAL APPROVED SUBJECT TO: PROPOSAL APPROVED SUBJECT TO: ❑ <br /> 2. Project meets zoning requirom•onts 1. Encroachment Permit ❑ 1. Sanitation Permit ❑ <br /> for both use and construction: 2. Traffic Mitigation Fees: 2. Well/pump Permit ❑ <br /> Yes 0- No❑ _ 3. Change Noted: ❑ <br /> 3. Schcol District Foes ❑ <br /> 4. Fire Facility Fee r4t,, ,1 ❑ PHCPCSAL DENIED: ❑ <br /> 5. Flood Fringe dry C ❑ <br /> 6. Subdivision History 3. Flood Control Conditions: 4. Remarks: <br /> 7. R"eLmarks4 / r r/ E e: l j <br /> 4. Remarks: <br /> Dater !� 92 By: j Date: By: Date: By: <br /> Second Unit Dwelling Address: ,��J �1/c!y 1 <br />