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PLAN MAP AMENDMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> rmv,, <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider 'Required Water(F et) <br /> Proposed E] <br /> Existing El <br /> Private Water Existing Well [D New Well Well Replacement 0 <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed El <br /> Existing E] <br /> On-site Sewage <br /> DisposalExisting Septic System Other New Septic Syste"NAV ❑ <br /> JV <br /> 40" <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed F Required to: Ponds <br /> Existing Ej <br /> Private Storm <br /> Private <br /> I <br /> Drainn a On-site Retention Pond(s) Natural Drainage/No Change El Other C1 <br /> EI®cticlty T <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> 6 <br /> ;Pdh001.SGrV4c6. 2 Fit,6In;Service <br /> Distance <br /> o <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> AExhfflri:0,-Ro9d9 <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> HwA4,JT"i� Ai 5 D 3 r YesE] N619 Yes D NoR <br /> Yes r es El No El <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 /> 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 /> All <br /> KDEVSVOPlanning Application Forml Page 5 of 7 <br /> Plan Application Amendment.doc.(Revised 6-03-04) <br />