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APPLICATION ® VARIANCE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> �I. FILE NUMBER: VR- <br /> N SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> I Annex-Formation Distance to Public <br /> Public Water <br /> Ip Service Provider Required Water Feet <br /> Proposed❑ IM <br /> Existin <br /> 4 Private Water❑ . Existing Well ❑ New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage a Annex-Formation Distance to Public <br /> DisposalService.Provider Required Sewer Facility <br /> Proposed �I <br /> i <br /> Existing DNA <br /> On-site Sewage I� <br /> Disposal❑ DNA Existing Septic System ❑ New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Ann <br /> Drainage . �! Service Provider{if Public) ex-Formation Terminal Drainage Detention-Retention <br /> Proposed ❑ III Required to: Ponds <br /> Existing ® DNA <br /> Private Storm j <br /> Drainage❑ On-site Retention Ponds) ❑ Natural Drainage/No Change ❑ Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> I Service Provider Service Service Provider Distance to Service <br /> MANTECA P;GE 40 DNA •DNA <br /> School Service Fire Protection Service <br /> Service Provider Distance to Elem <br /> School Service Provider Distance to Fire Station <br /> DNA IN <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> MANTHEY ROAD 2 Lane 2 Kabe yes❑ No12S Yes❑ Nob <br /> I� Yes ❑ No❑ Yes ❑ No ❑ <br /> I <br /> 4 j <br /> i <br /> I <br /> I <br /> t <br /> FMEVSVCIPianninq Appkaiion'FormsWanance.doc(Revised 8-18-04) Page'3 of 7 <br /> I <br /> �p <br />