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APPLICATION- MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ' �RE3P05;�D PAF�CELS , <br /> Parcel Number Existing or Proposed Use of Parcel Square Footage <br /> or Acreage <br /> /Z/� �c . <br /> SdT ,IMPRC?VEMENTS AND S. RiIlGES <br /> rNaier <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Existing ❑ Required Water(Feet) <br /> Proposed❑ <br /> Private Water . Existing Well El New Well Well Replacement ❑ <br /> �ewag Dis sag <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal Required Sewer Facility <br /> Existing ❑ <br /> Proposed❑ <br /> On-site Sewage Existing Septic System ❑ New Septic System 6Y Other ❑ <br /> DisposalX. <br /> $# <br /> o ret`Ofti <br /> Public Storm service Fovidc. Annex-Formation Terminal Drainage Detention- <br /> Drainage _ Required to: Retention Ponds <br /> Existing ❑ �---�- __T <br /> Proposed ❑ <br /> Private Storm Or,-site Retention Pond(s) ❑ Natural Drainage/No Change O;'her ❑ <br /> Eteattt�#ry Vaturai Gad <br /> Service Provider Distance to Service Service Provider Distance to <br /> Service <br /> Teieph�one SernueFable Tdev�smn Servtae <br /> Service Provider Distance to Service Service Provide; Distance tF. o <br /> Service <br /> Schoof:: 6 ae ' <br /> :.:. .. <br /> ::•:; r <br /> �e Prtiieciioi?Setvlire <br /> Service Provider Distance to Elem Service Provider Distance to Fire <br /> School Station <br /> T <br /> X. <br /> -:: <br /> t g Ftoac...... : .. <br /> Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks <br /> J Yes❑ No Yes❑ No�( <br /> Yes❑ No❑ Yes❑ No❑ <br /> _..: <br /> PrOpAsad"H 0" <br /> i Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> -3- <br />