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APPLICATION- MINOR SUBDIVISION
<br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
<br /> RRCPOSED PARCELS
<br /> Parcel Number Existing or Proposed Use of Parcel Square Footage
<br /> or Acreage
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<br /> RH Mg.
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<br /> Public Water Service Provider Annex-Formation Distance to Public
<br /> Existing❑ Required Water(Feet)
<br /> Proposed❑
<br /> Private Water❑ Existing Well New Well ❑ Well Replacement ❑
<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 X 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
<br /> Existing ❑
<br /> Proposed❑
<br /> Private Storm On-site Retention Pond(s) ❑ Natural Drainage/No Change ❑ Other jy
<br /> Drainage❑ 17l)7-
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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 /> Road/Street Name
<br /> R.O.W./Width Pavement Width Curb/Gutter Sidewalks
<br /> ER Yes❑ No Yes ❑ No
<br /> Yes❑ No❑ Yes❑ No❑
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<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-
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