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1K ' • t I ! <br /> f �Q APPLICP� ION - VARIANCE <br /> w SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: VR- <br /> .......... <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed❑ <br /> Existing❑ <br /> Private Water Existin Well ❑ New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed ❑ <br /> Existing <br /> ❑ <br /> On-site Sewage <br /> Disposal ® Existing Septic System ❑ New Septic System ® Other [I <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Required to: Ponds <br /> Proposed❑ <br /> Existing ❑ <br /> IFPrivate Storm <br /> Drainage❑ On-site Retention Pond(s) ❑ Natural Drainage/No Change ® Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> P.G.&E. Adjacent AT & T Adjacent <br /> School Service Fire Protection Service <br /> Service Provider Distance to Elem Service Provider Distance to Fire Station <br /> School <br /> Farmington 2 Miles Farmington 1.5 Miles <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Escalon—Bellota Road 60' 26' Yes❑ No® Yes El No <br /> i <br /> Yes -] No ❑ Yes[I No El <br /> I <br /> i <br /> I <br /> I <br /> FADEVSMPlanning Application FormsWariance.doc.(Revised 5-11-09) Page 3 of 7 <br /> 4 <br /> t <br />