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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
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<br /> Public Water Servk»Provider Annex-Formation Distance to Public
<br /> Existing O Required Water(Feet)
<br /> Proposed❑
<br /> Private Water Existing Well New Well ❑ Well Replacement ❑
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<br /> Public Sewage Service Provider Annex-Formation Distance to Public
<br /> Disposal Required Sewer Facility
<br /> Existing❑
<br /> Proposed O
<br /> On-site Sewage Existing Septic System New Septic System ❑ Other ❑
<br /> Disposal
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<br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detention-
<br /> Drainage Required to: Retention Ponds
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<br /> Proposed❑
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<br /> Drainage❑
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<br /> Service Provider Disunce to Eiem Service Provider Distance to Fire
<br /> School Station
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<br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks
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<br /> Yee❑ No O Yes O No O
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<br /> -3-
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