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g4U1" PLAN MAP AMENDMENT Q 1 s SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT FILE NUMBER: - %F • IL Annex ormaYion Distance to Public Putilic Water Service Provider Required Water Feet Proposed ❑ Existing❑ Private Water Qt] Existing Well ❑ New Well Well Replacement ❑ y,s ya��rt �' �:vi��.-�d.,f,T�.�. 4;`:n1W's te'w-: ti' :f.r. � .- LL ?�ta J � �'x�r��5`°��a��, H �,,1•�`y�...d Public Sewage Annex=Formation Distance to Public Disposal Service Provider Required Sewer Facility Proposed ❑ Existin ❑ On-site Sewage Disposal Existing Septic System ❑ New Septic System Other ❑ Public Storm Annex-Formation Terminal Drainage Detention-Retention Drainage Service Provider(if Public) 9 Proposed ❑ Required to: Ponds Existing ❑ Private Storm Drainage On-site Retention Pond(s) Natural Drainage/No Change ❑ Other ❑ Electricity Telepftone Service - Distance to Service Provider Service Service Provider Distance to Service School Service Fire Protection Service Distance to Elem Service Provider School Service Provider Distance to Fire Station A-1-7- Tp/aT /UoeA82c A6� Existing Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks �/ Yes C] No(f Yes El No,CI w ErL O}4 L r fL,tr/a Yes E] No[� Yes ❑ No Lh ENVIRONMENTAL INFORMATION USE ADDITIONAL PAPER, IF NECESSARY Water,Drainage and Flooding Describe any areas subject to flooding (include flood depths and flood panel map number): 69Egn! )AT MW,17F Vg 7Z0+T 'liP60 •24ve ? e- 7V o rc &- Su ttT 7v F�o��•v� . Describe the current depth of the ground water and depth t6 potable water: a/t T� �FL�RriN eo-FVlfl eg OST AY Describe any existing drainage courses or eroded areas on or near the project site(e.g.rivers,creeks,swales or drainage ditches): F:\DEVSMPlanning Application Forms\ Page 5 of 7 Plan Application Amendment.doc.(Revised 6-03-04)