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APPLICATION - LOT C.AE ADJUSTMENT <br /> j A@dl4AQ#I # tT }MM (DNT <br /> . VELOP <br /> ELI'I�' <br /> FILE NUMBER: <br /> PROPOSED-PARCELS'.' <br /> Existing Square Proposed Square <br /> Paftbl Ni:iMb&r Existirrg-or­PT2osed Use of Parcel <br /> h lg <bt <br /> 0 5� Ar <br /> s <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service.Pravider -Re uired Water Feet <br /> Proposed[� <br /> Exisfin <br /> Private Water Existing Well ❑ New Welt Well Re acemenl <br /> -Sewage-Disposal <br /> Public SewageAnnex-F,amiation Distance to Public <br /> -Disposal 8irrvicc�ravider 'R uireid SewarFaclt' <br /> y. <br /> Proposed�. <br /> Existing <br /> E On-site Sewage <br /> Dis osaf Existin `Se tic"S stem .[ New Se tic Systern `Other ❑ <br /> Storm"DraInage <br /> Public Storm <br /> I. Drainage Service RraLclder{if.Putalic). Annex-Formation. Terminal Drainage Detention-Retention <br /> -Proposed-[] Required to: Ponds <br /> Existing[] <br /> Private Stoim <br /> Drainage On-site Retention Pond s ❑ Natural Drainage/No Chane . Other ❑ <br /> i' Elocb icit' Telephone-servi-ce <br /> T Distance to <br /> Sarvice.Provider _,Service . Ser..vice.P,mvider _LDistance_tn Service <br /> 2. C'2 E a'r•- st S�3 C elk <br /> Mstance-to-Elam <br /> Service Provider School Service Provider Distance to Fire Station <br /> .-Existin .Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> � r <br /> lq Yes-El' <br /> No Yes❑ No <br /> Yes❑ No❑ Yes❑ No❑ <br /> Proposed Roads <br /> i Road/Sfceef-Name. - R.Q.W;Width:. Pavement Width- CurWGufter:' SideWWka.' <br /> Yes,[] No❑ Yes(3 No❑ <br /> Ye s.❑ NVo,❑ Yeses Non <br /> FADtVsvcTIannin9 Appl"tiori i=onm\ -Page-4 6 <br /> 1-J.1n AA1...w...,.. <br /> I <br />