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s. <br /> oKck APPLICATION SITE APPROVAL <br /> PRIVATE RIGHT OF WAY -- ANTIQUATED SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ;P.. FILE NUMBER: SA- <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed❑ <br /> Existing❑ �L L '/2f r✓� �X/f <br /> Private Water❑ Existing Well ❑ New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed❑ _ <br /> Existing[IIVA 5'61077e 17R!V411� 1901 s <br /> On-site Sewage <br /> Disposal❑ Existing Septic System ❑ New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed ❑ Required to: Ponds <br /> Existing❑ <br /> Private Storm <br /> Drainage❑ On-site Retention Ponds Natural Drainage/No Chane ❑ Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Se ice Provider Service Service Provider Distance to Service <br /> r School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> �/�21L' �7r?�'" �/S'jJ'7/l~7' f. s I'»i L rS /f v✓>� <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> "I_0440 /J/b' '� /M�jl�r �S 1�! Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes ❑ No❑ <br /> F OEVSMPlanning Application Forms\Site Approval) Page 3 of 7 <br /> Private Right of Way.(Revised5-11-09 <br />