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APPLICATION - SECOND UNIT DWELLING
<br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
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<br /> FILE NO.: SD-
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<br /> Owner IMormatfon Appileant Mformalfor[
<br /> Name: J QS Name:
<br /> Address: &AgAddress:
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<br /> Phone: as 7 Phone:
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<br /> Description of the proposed project: 5 /_
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<br /> Occupant(s)- Name: Age:
<br /> Name: Age:
<br /> Square Footage of Second Unit Dwelling: yQ LX a GI/
<br /> Year Mobilehome constructed (if applicable): / 220
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<br /> Assessor Parcel Number(s) Property Size Williamson Act
<br /> Contract
<br /> �� — C Q � Yes ❑No
<br /> Property Address: ��1�(O 3 Do/z aili
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<br /> Onsite Uses (Include Ag Crops):
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<br /> Service Provider Annex-Formation Distance to Public
<br /> Public Water❑ Required Water(Feet)
<br /> Private Water❑ Existing Well New Well ❑ Well Replacement ❑
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<br /> Public Sewage Service Provider Annex-Formation Distance to Public
<br /> Disoosal ❑ Required Sewer Facility
<br /> On-site Sewage Existing Septic System New Septic System 11 Other ❑
<br /> Disposal ❑
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<br /> Public Storm Service Provider(if Public) Annex-Formation Terminal Drainage Detention-
<br /> Drainage Z Required to: Retention Ponds
<br /> -.a:e Storm On-site Retention Pond(s) ❑ Natural Drainage/No Change Other ❑
<br /> ::-ainage❑
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<br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks
<br /> Yes❑ No Yea❑ NoIX
<br /> Yes❑ No❑ Yes❑ No❑
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