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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 /> Existing X Yes D No �yA.�.,e+►.6� o`^' <br /> Pronosed 1Z <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 ?G V�lkA C-$ Yes %-; No � <br /> Proposed -Z <br /> On-Site Sewage Disposal., Existing Septic System Ll 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 c Yes <br /> Proposed No )e— No <br /> Private Storm Drainage: On-site Retention Pond(s) Natural Drainage/No Change <br /> Other: <br /> ELECTRICITY <br /> Service Provider: Distance to Service: <br /> Pt11 a►-r�r+-�� E�w <br /> TELEPHONE SERVICE <br /> Service Provider: ; i Distance to Service: <br /> SCHOOL SERVICE <br /> District Distance to School: <br /> Elementary.- <br /> L__ A-A <br /> High School: <br /> L_-�_& � <br /> FIRE PROTECTION SERVICE <br /> Service Provider: vtk�� C� 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 O Yes <br /> i) No <br /> Yes N No Yes No <br /> -4- <br />