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°g4utry PLAN MAP AMENDMENT <br /> < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: - <br /> 4� <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed_❑ <br /> Existing <br /> Private Water Existing Well New Well ❑ Well Re lacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facilit <br /> Proposed❑ <br /> Existin ❑ <br /> On-site Sewage <br /> Disposal Existing Septic System New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ Required to: Ponds <br /> Existing❑ <br /> Private Stonn <br /> Drainage X On-site Retention Pond(s) Natural Drainage/No Change ❑ Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> ServiceProvider Service Service Provider Distance to Service <br /> �(® E5 <br /> School Service Fire Protection Service <br /> Service Provider Distance to Elem Service Provider Distance to Fire Station <br /> School <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> ( Z Yes❑ No Pj Yes❑ No jrshuL <br /> Yes❑ No❑ Yes❑ No❑ <br /> ENVIRONMENTAL INFORMATION <br /> (USE ADDITIONAL PAPER, IF NECESSARY) <br /> Water, Drainage and Flooding <br /> Describe any areas subject to flooding (include flood depths and flood panel map number): <br /> 14CAle <br /> Describe the current depth of the ground water and depth to potable water: <br /> Describe any existing drainage courses or eroded areas on or near the project site(e.g. rivers,creeks,swales or drainage ditches): <br /> 0A� <br /> F:\DEVSMPlanningApplication Forms\ Page 5 of 7 <br /> Plan Application Amendmentdoc.(Revised 05-11-09 <br />