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<br /> APPLICATION- MINOR SUBDIVISION
<br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
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<br /> 71
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<br /> Parcel Number Existing or Propoeed Use of Parcel Square Footage
<br /> or Acreage
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<br /> Public Water Service Provider Annex-Formation Distance to Public
<br /> Existing❑ Required Water (Feet)
<br /> Proposed❑
<br /> Private Water❑ Existing Well p New Well Well Replacement 13n:+�f4r.%!•}x�......P p .x :;M,`C:.
<br /> Public Sewage Service Provider Annex-Formation Distance to Public
<br /> Disposal Required Sewer Facility
<br /> Existing❑
<br /> Proposed❑
<br /> On-site Sewage Existing Septic System New Septic System Other ❑
<br /> Disposal❑
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<br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detention-
<br /> Drainage Required to: Retention Ponds
<br /> Existing❑
<br /> Proposed❑
<br /> Private Storm Or-sRe Retention Pond(s) ❑ Natural Dralnage/No Chango Other ❑
<br /> Drainage❑
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<br /> Service Provider Distance to Service Service Provider Distance to
<br /> Service
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<br /> Service Provider Diehnce to Service
<br /> Service provider Distance to
<br /> Service
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<br /> Service Provider Distance to Elem Service Provider Distance to Fire
<br /> School Station
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<br /> Road/Street Name FL .'rr.L r YVWth Curb/Gutter Sidewalks
<br /> Yee❑ No 1`r Yes❑ N o x
<br /> Yee❑ No❑ Yes❑ No❑
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<br /> Road/Street Name RO.W.Width Pavement Width Curb/Gutter Sidewalks
<br /> Yes❑ No❑ Yes❑ No❑
<br /> Yes❑ No❑ Yea❑ No❑
<br /> -3-
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