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Ar PUCAT)ON - LOT UNF ADJUSTS ENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> PROPOSED PARCELS <br /> E)dsting Square Proposed Square <br /> Parcel Number or Proposed Use of Parcel Foataqe or Acreage Foote a or AmW <br /> E CY�4 51o.// +— Y2 YZ,ar f <br /> Z T7rY6 O 54,72 4&"/— <br /> flrteff /�E,Z /lBdA PE2 <br /> A55E��K- fi w 5,ter <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Ann tion Distance to Public <br /> Public Water Service Provider R aired Water Feet <br /> Proposed ❑ <br /> Existi __ <br /> Private Waterl®- Exiisting WeM 4�1_ New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Anne(-Fornation Distance to Public <br /> Disposal Service Provider Re uired Sewer Facifi <br /> Proposed❑ <br /> E)dsting❑ <br /> On-site Sewage H�o5 iA�CF ❑ <br /> New Septic System El Other 141A <br /> _—D <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Pubic) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ Required to: Ponds_ <br /> E)dsting❑ <br /> Private Storm <br /> Drains la— On-site Retention Ponds ❑ Natural Drainage/No Chancre jd Other ❑ _ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> C cN-s S e--- <br /> School Service Fire Protection Service <br /> Distance to Elam <br /> SOFViM Provider School Service Provider Distance to Fire Station <br /> E)dsdng Roads <br /> Road/Slreet Name R.O.W.WkIth Pavement Width Curb/Gutter Sidewalks <br /> a .6 .-t {" You❑ No)- Yes❑ NOR <br /> r / Yes❑ No[& Yes❑ No[a, <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> F:Vevsvcv�ooing App=tion Fa % Page 4 of 7 <br /> Lot ung Adimb-I err fiM Pe~05-11-M) <br />