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PROPERTY SITE IMPROVEMENTS AND SERVICES <br /> WATER <br /> Distance to Public Water <br /> Public Water Service Provider: Annexation or Formation Required (ft.) <br /> nn <br /> Existing 1 Yes O No <br /> —Proposed <br /> Private Water: Existing Well O New Well O <br /> Other. <br /> SEWAGE DISPOSAL <br /> Public Sewage Disposal Service Provider: Annexation or Formation Required? Distance to Public Sewer <br /> Facility(miles) <br /> Existing ;K- oAuk Yes J No X,, <br /> Proposed -,si( I <br /> On-Site Sewage Disposal: Existing Septic System 1.7 New Septic System ;! <br /> Other: <br /> STORM DRAINAGE <br /> Public Storm Drainage Service Annexation or Detention-Retention Terminal Drainage to: <br /> Provider: Formation Required? Ponds? <br /> Existing Yes Yes ,?C <br /> Proposed wt%A C-5jN No No 11 <br /> Private Storm Drainage: On-site Retention Pond(s) Natural Drainage/No Change u <br /> Other. <br /> ELECTRICITY <br /> Service Provider: J , Distance to Service: <br /> TELEPHONE SERVICE <br /> Service Provider: y ` Distance to Service: <br /> SCHOOL SERVICE _ <br /> District Distance to School: <br /> Elementary: T <br /> L_ LA SJ) <br /> High School: <br /> FIRE PROTECTION SERVICE <br /> Service Provider: vtk L�C$ c s Distance to Fire Station: <br /> EXISTING ACCESS ROADS <br /> Road/Street Name R.O.W. Width Curb/Gutter Sidewalks <br /> Pavement Width <br /> Yes No i1 Yes a No i <br /> Yes u No i I Yes 7 No r_i <br /> -4- <br />