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,%WWI Sewage Disposal v <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed❑ NA NA NA <br /> Existing❑ <br /> On-site Sewage <br /> Disposal❑X See Existing Septic System ❑ New Septic System ❑ Other ❑X <br /> Project Description <br /> Storm Drainage <br /> Public Stonn <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ Required to: Ponds <br /> Existing❑ <br /> Private Storm <br /> Dra ❑ <br /> inage X See On-site Retention Pond(s) El Natural Drainage/No Change ❑ Other ❑X <br /> P!O ed Description <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> PGE 500 feet SBC 500 feet <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> NA NA None NA <br /> F'.1DEVSVOPlaning Application Forms\Use Penmt(Revised 6-03-0C) Page 8 of 9 <br />