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APPLICATION- MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> PROPOSI«®PARCELS <br /> Parcel Number Existing or Proposed Use of Parcel Square Footage <br /> or Acreage <br /> ^^ SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water C1 Service <br /> Water(Feet) <br /> Private Water❑ Existing Well ❑ New Well Well Replacement ❑ <br /> Di Poem <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal❑ Required Sewer Facility <br /> On-site Sewage Existing Septic System ❑ New Septic System Other ❑ <br /> Disposal❑ <br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detention- <br /> Drainage❑ Required q to: Retention Ponds <br /> Private Storm On-site Retention Pond(s) ❑ Natural Drainage/No Change Other ❑ <br /> Drainage❑ <br /> i;i:;?Viz:::,'''»:: <: :> >:::< >i:.'` `af;^i i,;. .. <br /> Elect►icity <br /> ................................................:...:.. <br /> Service Provider Distance to Service Service Provider Distance to <br /> Service <br /> s r! 1,0(5; lfi7.�vlo7.di l <br /> .:; etehnnc S�-rvica Cable Television Servicq <br /> Service Provider Distance to Service Service Provider Distance to <br /> Service <br /> :�er�uoi :servtc a dire P�oleq ton SetviQe <br /> Service Provider Distance to Elam Service Provider Distance to Fire <br /> School Station <br /> cele firms t 2 <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Q /f <br /> Yes❑ No Yes❑ No)K <br /> Yes❑ Nor Yes❑ No}if <br /> �+t�oposed i4oefht ;:;: <br /> Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks <br /> Yea❑ No❑ Yes❑ No❑ <br /> Yes 0 No 0 Yes 0 No 0 <br />