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APPLICATION - MINOR SUBDIVISION <br /> f SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: MS- <br /> Existing Land Uses <br /> On-Site Uses(include Ag Crops): <br /> �t <br /> t Uses to the North: <br /> I Uses to the East: <br /> Uses to the South: <br /> Uses to the West: <br /> f <br /> t PROPOSED PARCELS ! <br /> pParcelNumber Existing or Proposed Use of Parcel Square Footage or Acreage II <br /> -�� <br /> r. <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water ; <br /> Public WaterAnnex-Formation Distance to.Public ! <br /> Service Provider <br /> Existing ❑ Required Water(Feet) { <br /> Proposed ❑ <br /> Private Water Existin Well. _ New Well ❑ Well Re lacement ❑ <br /> Sewage Disposal <br /> Public Sewage Disposal Annex-Formation Distance to Public <br /> g P Service Provider <br /> Existing Required Sewer Facility <br /> ❑ <br /> Proposed-------------------------- <br /> ❑ <br /> —i <br /> On-site Sewage Disposal® _ Existing Setic 5 stem_ New Septic System E] Other E] <br /> Storm Drainage <br /> Annex-Formation Terming! Detention <br /> Public Storm Drainage Service Provider Re uired Drainage t !� <br /> Existing ❑ q o Retention Pond„ ,! <br /> Proposed ❑ <br /> Private Storm Drainage I On-site Retention Ponds !I <br /> .- .�- ___- ( ❑ Natural Drains e/No Chane Other ❑ <br /> Electricity INatural Gas <br /> j Distance to Distance to <br /> Service Provider Service— Service Provider Servioe it <br /> ilf <br /> F:',DEVSVS�Plc,nning Application Form,.;Mnor Subdiviw)n'Rcv 12-09-04) Page 4 of 9 <br />