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APPLICATION- MINOR SUBDIVISION
<br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
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<br /> Parcel Number Existing or Proposed 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 ❑ New Well Well Replacement ❑
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<br /> Public Sewage Service Provider Annex-Formation Distance to Public
<br /> Disposal Required Sewer Facility
<br /> Existing❑
<br /> Proposed❑
<br /> On-slte Sewage Existing Soptic System ❑ New Septic System), Other ❑
<br /> Disposal
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<br /> Public Storm Service Provider Annex-Formation Terminal Dralnage Detention.
<br /> Drainage Required to: Retention Ponds
<br /> Existing❑
<br /> Proposed❑
<br /> Private Storm On-sits Retention Pond(s) ❑ Natural Drainago/No Change l`' Other ❑
<br /> Drainage
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<br /> Service Provider Distance to Service Service Provider Distance to
<br /> Service
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<br /> Sorvice Provider Distnnoe to Service 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/Stroet Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks
<br /> E T O L Yea❑ No8( Yes❑ NoX
<br /> Yes❑ No❑ Yee❑ No❑
<br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks
<br /> Pj Yes❑ No❑ Yes❑ No❑
<br /> Yee❑ No❑ Yes❑ No❑
<br /> -3-
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