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APPLICATION- MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> PROP09 Q ALS . <br /> Parcel Number Existing or Proposed Use of Parcel Square Footage <br /> or Acreage <br /> SI`�.WF►ktPMEMENT ::,�AND',SERVICES' <br /> ...................................................................... <br /> `:: W,xlfer <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water❑ Required Water (Feet) <br /> Private Water Existing Well New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal ❑ Required Sewer Facility <br /> On-site Sewage Existing Septic System 04 New Septic System C Other ❑ <br /> Disposal <br /> Storm Drainage <br /> Public Storm Service Provider Annex-Formatior Terminal Drainage Detention- <br /> Drainage❑ Required to: Retention Ponds <br /> Private Storm On-site Retention Pond(s) ❑ Natural Drainage/No Change Other ❑ <br /> Drainage❑ <br /> Electricity Natural Gas <br /> Service Provider Distance to Service Service Provider Distance to <br /> Service <br /> �. A-7 e � <br /> Telephone Service Cable Television Service <br /> Service Provider Distance to Service Service Provider Distance to <br /> Service <br /> _Z2 <br /> School Service fire Protection Service <br /> Service Provider Distance to Elem Service Provider Distance to Fire <br /> School Station <br /> $v3sting','Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Sr Yes ❑ No C3-�_ Yes❑ No 9-' <br /> Yes❑ No❑ Yes❑ No❑ <br /> Propvttect <br /> Roads <br /> ........ <br /> Road/Street Name R.O.W.Width Pavement Widt Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> Yes 0 No 0 Yes 0 No 0 <br />