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= f3 II <br /> E9 L <br /> T.LINE,ADJU5.TMENT _ <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT- <br /> Parcel Number Existing or Proposed Use of Parcel `S Exlslfng Proposed <br /> k <br /> Square Footage Square Footage •. _ j. <br /> or Acreage or Acreage <br /> T <br /> f <br /> kPublfc Water 7 Service Provider Annex-Formation Distance fo Pub!!e <br /> XExlsting© " Required Water(Feet) <br /> Proposed❑ [I <br /> Private Water i4 Existing Well ❑ New Well .;,, Well Replacement ❑ <br /> § 1 <br /> Public Sewage „ Service Provider Annex-Formation Distance to Public <br /> } Disposal. Required Sewer Facility <br /> .I[Fxdsting❑ <br /> Proposed❑ <br /> On-site Sewage ?I' Existing Septic System ❑ New Septic System Other ❑ <br /> "I Dlspossi I. <br /> F <br /> Y <br /> Public Storm Service Provider Annex-Form tion Terminal Drainage Detention- <br /> !`'Drainage ! Required' to: Retention Ponds <br /> '�Exlsting❑ <br /> Proposed❑ <br /> Private Storm On-site Retention Ponds) Natural Drainage/Na Change ❑ Other ❑ <br /> Drainage❑ <br /> 81 �! <br /> I Service Provider Distance to Service Provider Distance to ' <br /> Service Service <br /> �,;� �. <br /> Service Provider „Distance to Servlce Provider Distance to <br /> i Service Service <br /> On2.�S e : <br /> 5' oii .s IF1Ce tsrotectlo►r5ervice a �! <br /> Service Provider Distance to Elem Service Provider Distance to Fire <br /> i School Station I: <br /> MIN <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter. Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> 7. <br /> Yes❑ No❑ Yes❑ No❑ <br /> r <br /> " il11tYS I <br /> E� Road/Street Name R.O.W-Width Pavement Width Curb/Gutter Sidewalks <br /> Yes E3 No❑ Yes❑ No❑. <br /> Yes❑ No❑ Yes❑ No❑ <br /> t:N AMP/�U70 FaArurry 1.10Cp it ., <br /> -3- <br /> 0 <br /> 3_ <br /> r r <br />