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F <br /> APPLICATION- SITE APPROVAL <br /> PRIVATE RIGHT OF WAY- ANTIQUATED SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> Public Water ' Service Provider Annex-Formation Drstaaee to Pubirc water i <br /> q Foe <br /> PExisting <br /> Private Water❑ Existing Well L7 New Well ❑ Walt Replacement ❑ <br /> Sev ge,D ss <br /> i <br /> Public Sewage Service Provider j Annex-Formation Distance to Public Sewer <br /> Disposal Required Facility <br /> Proposed❑ <br /> Existing O v/� <br /> On-site Sewage Existing Septic System O New Septic System ❑ Other ❑ ' <br /> Disposal❑ <br /> Storm ra�,,w Maga ti ' <br /> � t Yu'.:w: L• :iu x: :•it S <br /> i <br /> %. Public Storm Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Drainage Required to: Ponds j <br /> Proposed O <br /> Existing❑ 1 ;' <br /> 3i Private Storm On-site Retention Pond(s) ❑ Natural Drainage/No Change Other ❑ <br /> Drainage' <br /> Lei x l C Cl fy' F£�4 * 3s. @ ` T@ pI1017@.7 BIY1/C8 ' <br /> ,..t K:Y�d.;.. ?: f 11 ��51 :rn,a... <br /> Service Provider Distance to Service i Service Provider Distance to Service I <br /> g2W S ff�i' �i6 1Z-� a <br /> C.� i <br /> TMOr� lir :; t r <br /> PonSchool Seniice � FirePro ectran Serce,�pf �l g <br /> ., ..� ,i .vw�.cwe.., a+:rnf= 'd.�rf.. ,4 s, it. Mom <br /> :te. ... mar• ;i . <br /> Service Provider Distance to Elam Service Provider Distance to Fire <br /> - School Station f <br /> a <br /> R !Pow GAN [ /� �• jPDN ; . as i <br /> s <br /> isf1 0a <br /> Road/Street Name R.O.W-Mdth Pavement Width. Curb/Gutter Sidewalks <br /> WA ROAD �{v v Yes❑ No Yes O. No <br /> Yes No AV- Yes© No <br />/ E1 <br /> d �II <br /> ' 11 <br /> ft <br /> I� 1 <br /> :1 <br /> 7 <br /> s <br />�.yf..a._ .. , .-.". .. _. TM,_ ".�--r-4+�•-..^=.��.�._...._..e"..�..n..��.w"s'�^�ti�a_at�.��...... M+Yr.�"�Ys�''--`�fa�c�•.�w+.�n� ' S�'e '--rbi�.:. <br /> e� <br /> J. <br /> j <br /> 31MPPROPRIANTIFOPMIYAPP RL0,8-9-01 41X01 <br /> —3— <br /> n <br />