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APPLICATION - QUARRY EXCAVATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> APPLICATION FORM - -_ -- <br /> LAddress: <br /> TSS SE COMPLETED BY THE APPLICANT PRIOR TD FILING THE APPLIC,l TIONApplicant IMormatlon Applicant InformationG� Name: (73 - ko -7P,O Ie}-Z Address: c)- x 6 r <br /> NvL-i (-A ei 52 ,-P 1 uuj S 2.3 L1 <br /> Phone: nc._i>�ir l- 1�5�. �'1 I j Phone: 2('DC ('S 73 <br /> PROPERTY AND VICINITY t)ESi HIP TION <br /> Property Information <br /> Assessor Parcel Number(s) Property Size Number of Parcels Williamson Act <br /> /� 1 , ` I Contract <br /> rT PN : I - (� "� I 313 .-6 � Ulv"C Ayes ❑No <br /> Property Address'. <br /> Eidalli/ nd ng LaU;ae <br /> On Site Uses (Include Ag Crops): A b L 14 L <br /> C.oQN /? S P/q2A Mfrs l i�Ki,�i <br /> Uses to the North: L /, L <br /> Uses to the East: �6 k I cV(�'�U/C/-(, <br /> 6 ww e r <br /> Uses to the South: Mr �G/Z u(--I L)(Y _A <br /> Uses to the West: �� `� (, "j�U/1AL <br /> -- ---- <br /> CL) P d1 C�X1.5 l f <br /> �— SITEIMPROVEMENI5 AND SERVICES <br /> Water <br /> Public Water: Service Provider Annex-Formation Required T=e to Public Water(Feet) <br /> Existing ❑ <br /> Proposed ❑ <br /> Private Water Existing Well El <br /> Nzw Well ❑ Well Replacement ❑ <br /> :.Sewage Disposal <br /> Public Sewage Disposal: Service Provider Annex-Formation Required Distance to Public Sewer <br /> Existing ❑ Facility <br /> Proposed ❑ <br /> A/0/jR Pos�/> <br /> On-site Sewage Disposal ❑ Existing Septic System E New Septic System ❑ Other ❑ <br /> Public Storm Drainage: Annex-Formation Required Terminal Drainage to: Detention-Retention Ponds <br /> Existing ❑ <br /> Proposed ❑ <br /> Private Storm Drainage ❑ On-site Retention Pond(s) Natural Drainage/No Other ❑ <br /> Change ❑ <br /> -2- <br />