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APPLICATION- SITE APPROVAL <br /> PRIVATE RIGHT OF WAY- ANTIQUATED SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> , <br /> SITE IMPROVEMElffS AND SERVICES <br /> a d t 1i�pWlbT .T ' t. + Wsiter ';e ,e 417 . <br /> Public Wafer <br /> Proposed❑ Service Provider <br /> Annex Formation o/sranc•to Public Wirer <br /> Existing❑ Required (F••rl <br /> Private Wafer❑ Existing Well New Well ❑ <br /> Well Replacement ❑ <br /> a [ <br /> b P i i/e, b15µAb�l•6»< yy "fJ?",� ' �i' E� <br /> ewage'�D/Sposa/��r�4�'��7 �Tjt' L +�+ t ✓,V fi <br /> Public Sewage <br /> Disposal Service Provider Annex-Formation Di•1•nc•to Public So~ <br /> Proposed❑ Required F•crarr <br /> Existing❑ <br /> On-site Sowago Existing Septic System Now Septic System ❑ Other ❑ <br /> Dispose/❑ <br /> +I a,R�GIs r ll �^ ',•r ,'r�'a r r M1 <br /> •'M 47`pYl6!' ' # <br /> Public Storm Service Provider(if Public) Annex Formation Terminal Drainage Detention-Retention <br /> Drainege Required Proposed❑ Ro q fo: Ponds <br /> Existing❑ <br /> Private Storm On-site Retention Ponds ❑ <br /> Drainage❑ O Natural Drainege/No Change Othor ❑ <br /> Electricity tt, a t�l,�yj,F •i4r, to , •k ,.,. a F <br /> Service Provider Distance to Service <br /> Service Provider Distance to Service <br /> Schor 4 r "r;13 f 4 ri 1 fi S ,x z — <br /> ol'Serv�ce , eprofectionFu SIce' <br /> Service Provider Distance to Elem Service Provider <br /> School Distanceto FanStattation <br /> �f�' A ��7} �', +° d,{r�'.. .lin`b •4✓0 Nr v -`q viny p'' �rr� <br /> RoadrStmet Name R.O.W. Width Pavement Width <br /> Curb/Gutter Sidewalks <br /> Yes❑ No fad Yes❑ No rD/ <br /> ,;',� Yes❑ No f7� Yes❑ No tat <br /> -3- <br />