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I SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Existing O Required Water(Feet) <br /> Proposed O <br /> Private Water Existing Well O Now Well Well Replacement O <br /> Sewage Disposal <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal Required Sewer Facility <br /> Existing O <br /> Proposed O <br /> On-site Sewage Existing Septic System O New Septic System Other O <br /> n!LOL— <br /> Stormorm Drainage <br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detention- <br /> Drainage Required to: Retention Ponds <br /> Existing O <br /> Proposed O <br /> Private Storm On-sife Retention Pond(s) O Natural Drainage/No Changed Other O <br /> Drainage <br /> Electricity Natural Gas <br /> Service Provider Distance to Service Provider Dls fnnce to <br /> _ Service _ Sory/co <br /> E rV 51TE P � S1TE <br /> Telephone Service Cable Television Service <br /> Service Provider Distance to Service Provider Distance to <br /> Service Service <br /> FIC CELL ,V S ATE S <br /> School Service Fire Protection Service <br /> Service Provider Distance to Elem Service Provider Distance to Fire <br /> C (� School Station <br /> SL'q JJ liLl 5• ,J• a .5-Ml/ES /!-s 0_1W A)N Z>IUVTEE/e° F E <br /> Existing Roads <br /> WRoaNR.O.W Width Pavement Width Curb/Gutter Sidewalks <br /> Yas O NoYes O NO$Yes O No O Yes O No OProposed Roads <br /> R.O.W. Width Pavement Width Curb/Gufter Sidewalks <br /> Yes O No O Yes O No O <br /> Yes O No O Yes O No O <br /> ItlN.VnIJI/IINIF/I'V.XAYb/I,nLINGWAp/IIN1 PLY 1/1/#$ -l- <br />