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<br /> Public Water Service Provider: Annexation or Formation Distance to Public Water(ft.)
<br /> Required?
<br /> Existing ❑
<br /> Proposed ❑ Yes ❑ No ❑
<br /> Private Water: Existing Well ❑ New Well ❑ Other:
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<br /> Public Sewage Disposal Service Provider: Annexation or Formation Distance to Public Sewer
<br /> Required? Facility(miles)
<br /> Existing ❑
<br /> Proposed ❑ Yes[I No❑
<br /> On-Site Sewage Disposal: Existing Septic System ® New Septic System ❑ Other:
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<br /> Public Stomp Drainage Service Provider: Annex or Formation Terminal Drainage to: Detention-
<br /> Required? Retention Ponds?
<br /> Existing ❑
<br /> Proposed El Yes E] No[IYea❑ No ❑
<br /> Private Storm
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<br /> Service Provider: Distance to Service: Service Provider: Distance to Service:
<br /> PG&E _ ON SITE PAC BELT, ON SITE
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<br /> Dist.rioy Distance to School Service Provider DistAo,Fire Station
<br /> Elementary: BANTA 1 MILE
<br /> TRACY RURAL 1 MILE
<br /> Hi School: TRACY 7 MILES
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<br /> Road/Street Name R.O.W.Width Pavement Width Curb/Outter Sidewalks
<br /> KAS SON RD. Yes❑ No® Yea❑ No
<br /> Yes❑ No❑ Yes❑ No❑
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