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APPLICATION - VARIANCE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> r FILE NUMBER: VR- <br /> f SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed❑/ i <br /> Existin , Cfa ' vl1161 k ->✓ S�rUiC <br /> [—private Water❑ Existing Well ❑ New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed[ff <br /> Existin >C <br /> On-site Sewaqp <br /> Dis osada Existing Septic System ❑ New Septic System ❑ Other E] <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ Required to: Ponds <br /> Existing <br /> P <br /> Private Storm ` <br /> Draina e❑ On-site Retention Pond(s) ❑ Natural Drainage/No Change ❑ Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> OVI fnkT+ <br /> School Service Fire Protection Service <br /> Service Provider Distance to Elem Service Provider Distance to Fire Station <br /> School <br /> nc� �1,finen-1u,n.I YYI i I , Mile <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> e �d.U f Yes-0 No❑ Yes'[ . No❑ <br /> E,Pc-ZQ Yes ©� No❑ Yes No ❑ <br /> F:\DEVSVC\Planning Application Forms\Variance.doc.(Revised 5-11-09) Page 3 of 7 <br />