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APPLICATION- SITE APPROVAL <br /> PRIVATE RIGHT OF WAY- ANTIQUATED SUBDIVISION <br /> _ SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> E- SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> F,!Nic Water Service Provider Annex-Formation Distance to Public Water <br /> P,nposed O Required (Feet) <br /> L.<isting O <br /> Poi•;^rrm Waterff Existing Well U New Well A Well Replacement O <br /> Sewage Disposal <br /> Puhlic Sewage Service Provider Annex-Formation Distance to Public Sewer <br /> Disposal Required Facility <br /> Proposed O <br /> Existing O <br /> On-site Sewage Existing Septic System O New Septic System �1 Other p <br /> P.�sposal r \ <br /> Storm Drainage <br /> f"m:dic Storm Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Drainage Required to: Ponds <br /> Proposed O <br /> Existing O <br /> Prir,Rte Storm On-site Retention Pond(s) O Natural Drainage/No Change Other C <br /> Pr.ainage O <br /> Electricity Telephone Service <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> I � <br /> School Service Fire Protection Service <br /> Service Provider Distance to Elem Service Provider Distance to Fire <br /> School Station <br /> (�'C•: T V l�' <br /> // ' 1-ti _e <br /> Existing Roads <br /> Road/Street Narne R.O.W Width Pavement Width Curb/Gutter Sidewalks <br /> P/ Yes O Wo Yes O No <br /> Yes O No O Yes O No a <br /> SITEAPPR"PPIANTIFOMDIVAPP REV S-9-01 IIHDI <br /> -3- <br />