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APPLICATION- SITE APPROVAL <br /> PRIVATE RIGHT OF WAY_ ANTIQUATED SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 4 <br /> Proposed❑ Service Provider <br /> Annex-Formation D/slanc.to Public Water <br /> Existing❑ Required (Feat) <br /> Private Water, Existing Well 0 New Well <br /> Well Replacement ❑ <br /> Public Sewage <br /> Disposal Service Provider Annex-Famaiion o/crcc.m Public s.~ <br /> Proposed❑ Required F.c/tar <br /> Existing❑ <br /> On-site Sewage Existing Septic System 0 New Septic System Other 0 <br /> Dispose <br /> Public Storm Service Provider(it Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Drainage Required to: Ponds <br /> Proposed❑ <br /> Existing❑ <br /> Private Storm On-site Retention Pond(s) ❑ Natural DrainageiNo Changed Other ❑ <br /> Drainage <br /> I. ....i't-tr` 14,`.��,"''E eCtrlC�it �,.. t >< xrrrq ,s+ k•vy.. 'ra; <br /> �• �, Y�z� �, .. r e�. Telephone S�taICe <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> PQc, Z3eli Iso ' <br /> SchgDl SBNIC@}Pit� 8'tX/ § yi rR f fii (' �tf!pt v K qt) Y } <br /> a _rt ,t , FL,e#P_rofecfion ServlCe-ii,^E r <br /> Service Provider Distance to Elem Service Provider Distance to Fire <br /> / School Station <br /> Gct 0y`�yyySC <br /> lt`!'(�,�'i 1�� dW+ `htf' y .n��', , fit/ •4 Y, 'MkM�f`n' "nV.,B' it ' m . t � <br /> RoadUStreet Name R.O.W. W/dth Pavement Width CurbiGulter Sidewalks <br /> G O a i Yes❑ No Yes❑ No 0-- <br /> Yes❑ No❑ Yes❑ No❑ <br />