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PLAN MAP AMENDMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER. - - <br /> i SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Wate Feet <br /> Proposed <br /> Existing <br /> Private Water❑ Existing`Nell ❑ New`yell ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Fo,mation Distance to Public <br /> Disposal Service Provider Re uired Sewer Facility <br /> Proposed ' �' /V_d DQ� <br /> Existin ❑ / Vt <br /> On-site Sewage <br /> Dis osal❑ Existing Septic System ❑ New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Public Store o Annex-Formation Terminal Drainage Detention-Retention <br /> Drainage Service Provider(if Public) 9 <br /> Proposed Required to: Ponds <br /> Existing❑ <br /> Private Storm <br /> Drainage F.7 On-site Retention Pond(s) Natural Drainage/No Change ElOther ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> G E 7T A5_0 <br /> 1. School Service I Fire Protection Service <br /> j <br /> Service Provider Distance to Elem School Service Provider Distance to Fire Station <br /> u uWAlyzvc <br /> Existing Roads <br /> Road,Street Name R.O.W.Width Pavement Width CurbiGutter Sidewalks <br /> ,* Yes ❑ oYes ❑ o <br /> I ,t /q-6 Yes No❑ Yes No❑ <br /> ENVIRONMENTAL INFORMATION <br /> "JSE 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 /> kx <br /> Describe the current depth of the ground water and depth to potable water: <br /> Describe any existing drainage courses or eroded areas on or near the project site(e.g. rivers, creeks, swales or drainage ditches'j: <br /> F .DEVSVCPIann,ng Applica ice Fom s. Page 5 of 7 <br /> Plan Application Amendment.doc.(Revised 05-11-05 <br />