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❑ SERVICES <br /> List the public services and facilities which will be necessary for <br /> the project. Specify what public agency, if any, that will provide ) <br /> each . If private or individual services are proposed, explain: <br /> Are services cur- <br /> rently provided? Which City, Special District, <br /> If no, how far will etc. , will be providing each <br /> lines need to be service or what private <br /> Service extended? services are proposed? <br /> Water _Yes X No N/A <br /> Sewer _Yes X No N/A <br /> Drainage _LYes No Sa r - strict <br /> Electricity _LYes No P. <br /> Gas Yes No P. <br /> Yes No <br /> Proposed property size and use: <br /> Parcel A size: 138 Ac. use: <br /> Parcel B size: 260 Ac. use: Row CrnQ <br /> Parcel C size: N/A use: <br /> Parcel D size: N/A use: <br /> ❑ SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> Legal Owner(s ) (All owners must sign as their names appear on the <br /> deed. ) , <br /> ❑ Corporate Officer(s ) empowered to sign for the corporation, <br /> u Owner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application) , <br /> a that the foregoing is true and correct. <br /> cy 71k <br /> (Signatur ) (b to ) <br /> S u r e ate <br /> `7 _//2- <br /> i <br /> u e Date <br /> igna ure (Date) <br /> Lot L1 ne Ad ustittan t: Signature) Date <br />