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SAN ]H O U I N COMMUNITY DEVELOPMENT DEPARTMENT <br /> SITE APPROVALIUSE PERMIT <br /> FILE NUMBER: <br /> SERVICES <br /> Water <br /> Public <br /> ❑ Service Provider: Will Serve Letter Provided <br /> Distance to <br /> ❑ Public Water: <br /> Existing Well New Well Well Replacement <br /> Private I El <br /> Wastewater Disposal <br /> Public <br /> ❑ Service Provider: Will Serve Letter Provided <br /> Distance to <br /> ❑ Public Sewer: <br /> Existing Septic System New Septic System Septic System Replacement <br /> Private <br /> ❑ ❑ <br /> Description of process wastewater: Volume of process Method of disposal: <br /> If the project will result in wastewater: <br /> process wastewater provide <br /> the following information: <br /> Storm Drainage <br /> Service Provider: Will Serve Letter Provided Distance to <br /> Public ❑ <br /> El Drain: Storm <br /> Drain: <br /> Existing On-site Retention Pond New On-site Retention Pond Natural Drainage <br /> Private ❑ ❑ <br /> Other Public Services <br /> School Service Fire Protection Service <br /> Service Provider Distance to Service Provider Distance to <br /> L p D 4 V>J ; School: �� (Y\;L"" I Fire Statipn: <br /> Page 3 of 6 <br /> 08113/2021 <br />