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PLAN h..,P AMENDMENT <br /> { ti <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: - - <br /> �9�%FOR�`P <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed ❑ <br /> Existin <br /> FPrivate Water Existing Well New Well ❑ Well Re lacement ❑ <br /> Sewage Disposal <br /> Public Sewage =Required <br /> Formation Distance to Public <br /> Disposal Service Provider Sewer Facility <br /> Proposed U <br /> l Existing❑ <br /> 70n-site Sewage osal Existing Septic System New Septic System ❑ Other El <br /> Storm Drainage <br /> Pilhlir.Storm <br /> Drainage Service Provider(if Public) n r sTermin I Drainage <br /> ^iiiiex ation a netPntion-Retention <br /> Required to: Ponds <br /> Proposed ❑ <br /> Existing❑ <br /> Private Storm <br /> Draina el. On-site Retention Pond(s) Natural Drainage/No Change ❑ Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> '4/ <br /> School Service Fire Protection Service <br /> Distance to Elem Service Provider Distance to Fire Station <br /> Service Provider School <br /> —Jo TFA—Z <br /> Existin Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes ❑ No Yes❑ No,�f <br /> Yes ❑ No ❑ Yes❑ No❑ <br /> ENVIRONMENTAL INI-uRMATION <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 /> F:\DEVSVC\Planning Application Forms\ Page 5 of 7 <br /> Plan Application Amendment.doc.(Revised 11-05-07 <br />