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APPLICATION- MINOR SUBDIVISION
<br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
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<br /> Parcel Number Existing or Proposed Use of Parcel Square Footage
<br /> or Acreage
<br /> Home e 1-5 AG
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<br /> Public Water Service Provider Annex-Formation Distance to Public
<br /> Existing O Required Water(Feet)
<br /> Proposed D
<br /> Private Waterx Existing Well O New WellA Well Replacement 13 ]
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<br /> Public Sewage Service Provider Annex-Formation Distance to Public
<br /> Disposal Required Sewer Facility
<br /> Existing D
<br /> Proposed O
<br /> On-site Sewage Existing Septic System O New Septic System AN Other D
<br /> DtaposalX
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<br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detention-
<br /> Drainage Required to,. Retention Ponds
<br /> Existing❑
<br /> Proposed D
<br /> Private Storm On-site Retention Pond(s) Q Natural Drainage/No Chang' Other D
<br /> Drainage111 [
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<br /> Service Provider Distance to Service Service Provider Distance to
<br /> Service
<br /> 424 Free.
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<br /> Service Provider Distance to Service Service Provider Distance to
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<br /> School Station
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