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APPLICATION- MINOR SUBDIVISION
<br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
<br /> Parcel Number Existing or Proposed Use of Parcel Square Footage
<br /> or Acreage
<br /> SITE IMPROVEMENTS AND SERVICES
<br /> Wafer
<br /> Public Water Service Provider Annex-Formation Distance to Public
<br /> Existing p n Required Water (Feet)
<br /> Proposed❑
<br /> Private Water❑ Existing Well New Well ❑ Well Replacement ❑
<br /> :...
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<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 ❑ Other ❑
<br /> Disposal❑
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<br /> h.
<br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detention-
<br /> Drainage Required to: Retention Ponds
<br /> Existing❑
<br /> Proposed ❑
<br /> Private Storm On-site Retention Pond(s) ❑ Natural Drainage/No Change ❑ Other
<br /> Drainage❑
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<br /> Service Provider Distance to Service Service Provider Distance to
<br /> _ Service
<br /> - 00 F7_
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<br /> Service Provider Distance to Service Service Provider Distance to
<br /> Service
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<br /> Service Provider Distance to Elem Service Provider Distance to Fire
<br /> School Station
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<br /> /Roadd/'Str'eet Name R.O.W./Width Pavement Width Curb/Gutter Sidewalks
<br /> trl
<br /> Yes❑ No Yes ❑ No
<br /> Yes❑ No❑ Yes ❑ No❑
<br /> ::.:.
<br /> OS48
<br /> 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 />
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