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"`" APPLICATION — ZONE RECLASSIFICATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO. ZR- <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Q Service Provider Required Water Feet <br /> Private Water❑ Existing Well ❑ New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Annex-Formation Distance to Public <br /> Public Sewage Service Provider Required Sewer Facility <br /> Disposal❑ <br /> On-site Sewage DisLosal[g Existing Se 'c 20tem New Septic§ntem [a Other ❑ <br /> Storm Drainage <br /> Annex-Formation Terminal Detention- <br /> Public Storm Service Provider Required Drainage to: Retention Ponds <br /> Drainage❑ <br /> Private Storm Drainage❑ On-site Retention Ponds' Natural Drain e/No Change ❑ Other ❑ <br /> Electricity Natural Gas <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> Pia E zs � 14 9� �'_-cf,- <br /> Telephone Service Cable Television Service <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> y'e P 2� C-n/ l 0 F? <br /> School Service Fire Protection Service <br /> Distance to Elem. Distance to Fire <br /> Service Provider School Service Provider Station <br /> r= //v C GL3 -k7 0,EP7 <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> SC uTy Corn G 0,VFX A 0,4 p G G a_7 F T Yes❑ No Q Yes❑ No Q <br /> Yes❑ No❑ Yes❑ No❑ <br /> F:IDEVSVS1Planning Appbcabon Forms\ZONE RECLASSIFICATION Page 3 of 5 <br /> (Rev.05-11-09) <br />