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4u N \ APPLICATION - ZONE RECLASSIFICATION <br /> >.•.�L�'•.O <br /> W: <br /> ` SAN ")AQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: ZR- PA 1400155 <br /> {FOR/ <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water❑ Service Provider Required Water(Feet) <br /> =Private ❑ Existing Well ® New Well ❑ Weii Replacement ❑ <br /> Sewage Disposal <br /> Annex-Formation D s Public <br /> Public Sewage Service Provider Required Se",._.-Facility <br /> Disposal❑ <br /> NONE <br /> On-site Sewage Disposal ❑ Existing Septic System ❑ New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Annex-Formation Terminal Detention- <br /> Public Storm Service Provider Required Drainage to: Retention Ponds <br /> Drainage ❑ <br /> Private Storm Draina e ❑ On-site Retention Ponds ❑ Natural Drainage/No Chane IC Other ❑ <br /> Electricity Natural Gas <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> PG&E ON SITE NONE <br /> Telephone Service Cable Television Service <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> NONE NONE <br /> School Service Fire Protection Service <br /> Distance to Elem. Distance to Fire <br /> Service Provider School Service Provider Station <br /> NONE LOCKEFORD FIRE DEPARTMENT 3 MILES <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> FLOCKE ROAD <br /> 40 ' 24 ' Yes[I NoX] Yes❑ No <br /> Yes❑ No❑ Yes❑ No❑ <br /> F:\DEvsys\Planning Application Forms2ONE RECLASSIFICATION Page 3 of 5 <br /> (Rev.05-11-09) <br />