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COMMUNITY EPARTMENT <br /> SAN 10AQUINSITE APPROVAL <br /> COUNTY <br /> r <br /> FILE NUMBER: <br /> On-Site Parking <br /> Full-size Parking Compact Parking ADA Parking Total Parking <br /> Spaces (Number) Spaces(Number) (Number) Spaces(Number) <br /> Existing Proposed Existing Proposed Existing Proposed Existing Proposed <br /> 0 10 0 0 0 1 0 9 <br /> SERVICES <br /> Water <br /> Public Service Provider: Will Serve Letter Provided Distance to Public Water: <br /> _ ❑ <br /> Private Existing Well New Well Well Replacement <br /> ❑ ❑ <br /> Wastewater Disposal <br /> Public Service Provider: Will Serve Letter Provided Distance to Public Sewer: <br /> ❑ ❑ <br /> Private Existing Septic System New Septic System Septic System Replacement <br /> ❑ FEI ❑ ❑ <br /> Description of process Volume of process wastewater: Method of disposal: <br /> If the project will result in process wastewater: <br /> wastewater provide the following <br /> information: <br /> Storm Drainage <br /> Public Service Provider: Will Serve Letter Provided Distance to Public Storm Drain: <br /> ❑ ❑ <br /> Private Existing On-site Retention Pond New On-site Retention Pond Natural Drainage <br /> a ❑ ❑ a <br /> OTHER PUBLIC SERVICES <br /> School Service Fire Protection Service <br /> Service Provider Distance to School Service Provider Distance to Fire Station <br /> N/A ( N/A Montezuma Fire District I 1 .2 mi. I <br /> Page 3 of 6 <br /> Updated 0812812020 <br />