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APPLICt,-,i'ION - DEVIATION
<br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
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<br /> Service Provider Annex-Formation Distance to Public
<br /> Public Water Required Water(Feet)
<br /> Existing O
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<br /> Private Water Existing Well O 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 O
<br /> Proposed O
<br /> On-site Sew Existing Septic System O New Septic System �( Other ❑
<br /> Disposal
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<br /> Public Storm Service Provider (it Public) Annex-Formation Terminal Drainage Detention-
<br /> Drainage Required to: Retention Ponds
<br /> Existing ❑
<br /> Proposed O
<br /> Private Storm On-site Retention Pond(s) Natural Drainage/No Change ❑ Other ❑
<br /> Drainage O
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<br /> Service Provider Distance to Elem Service Provider Distance to Fire
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<br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks
<br /> Yes❑ N-19Yes❑ No
<br /> Yes O No❑ Yes❑ No O
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