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APPLICATION- MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> Parcel Number Existing or Proposed Use of Parcel Square Footage <br /> or Acreage <br /> / � s e Z <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water _ <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Existing ❑ Required Water (Feet) <br /> Proposed ❑ <br /> Private Water Existing Well New Well ❑ Well Replacement ❑ <br /> te@.. <br /> •. <br /> ........ ..... <br /> a, <br /> ::::..... <br /> fP <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal Required Sewer Facilky <br /> Existing❑ <br /> Proposed ❑ <br /> IFOn-site Sew a a Existing Septic System New Septic System ❑ Other ❑ <br /> Disposal <br /> • <br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detention- <br /> Drainage Required to: Retention Ponds <br /> Existing ❑ <br /> Proposed❑ <br /> Private Storm Onsite Retention Pond(s) ❑ Natural Drainage/No Change Other ❑ <br /> Drainage❑ <br /> 7. <br /> Service Provider Distance to Service Service Provider Distance to <br /> Service <br /> ..:.. ... :.::::. . :.:..}..... <br /> ..... ..... .:,.:.:.:.:.:.:..::.:.:}:.. <br /> ::..:.:}.. <br /> ::;:::;.:}::.:::::!::??:. <br /> ... ...... ... <br /> .::..:..:•:.:::::::: ..els t�, � ,•.:.}:•.}?:!!.}::;:.::'. <br /> Service Provider Distance to Service Service Provider Distance to <br /> Service <br /> �,51 <br /> ...�. <br /> .......:......::..;f+> ............ <br /> Service Provider Distance to Elem Service Provider Distance to Fire <br /> School Station <br /> 2 vr7. �O/�'P 5 a 6e <br /> < ► <br /> x Stin Dads ; :.:.::...... ..:.::. : :...:. <br /> RoadrStreet Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> / <br /> Q Yes❑ No Yes❑ No <br /> Yes❑ No❑ - Yes❑ No❑ <br /> [O <br /> l <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> Yes O No❑ Yes❑ No❑ <br /> -3- <br />