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(7) n <br /> 111 <br /> �,,� PLAN MAP AMENDMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FELE NUMBER: <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Public Water Service Provider Annex-Formation <br /> Proposed❑ Distance to Public <br /> Existin ❑ Re uired Water Feet <br /> Private Water Exj,:,i I.11111C Well <br /> New Well ❑ Well Re lacement ❑ <br /> Sewage Disposal <br /> Public Sewage <br /> p Disposal Service Provider Annex-Formation Distance to Public <br /> Proposed F1 Re uired Sewer Facili <br /> Existin ❑ <br /> On-site Sewage <br /> bis osaf Existing Septic System <br /> .�- New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ <br /> Existing❑ Re aired to: Ponds <br /> Private Storm <br /> Draina a 9 _: Electricity On-site Retention Ponds <br /> E] Natural Drainage/No Change's Other ElI <br /> Telephone Service <br /> Service Provider Distance to <br /> ` Service Service Provider <br /> a C ® , Distance to Service <br /> c <br /> School Service OA/. r <br /> Service Provider Distance to Elem Fire Protection Service <br /> School Service Provider Distance to Fire Station <br /> Existing Roads <br /> Road/Street!Name R.O.W.Width Pavement Width Curb/Gutter <br /> Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> ENVIRONMENTAL INFORMATION Yes❑ No❑ Yes❑ No❑ <br /> USE ADDITIONAL PAPER, IF NECESSARY <br /> Water, Drainage and Flooding <br /> Describe any areas subject to flooding(include flood depths and flood panel map number): <br /> Z D I O G Z <br /> Describe the current depth of the ground water and depth to potable water: et O Z_ <br /> oe <br /> o t/ `f <br /> oo <br /> Describe any existing drainage courses or eroded areas on or near the project site(e.g. rivers, creeks,swales or drainage ditches): <br /> o e-& 31WC_ D r- 8°� <br /> FIDFVSVC1Planning Application Forms% l a ✓Q A_ <br /> Plan Application Amendmenl.doc.(Revised 05-11-09 Page 5 of 7 <br /> 3 <br />