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QUI COMMUNITY DEVELOPMENT DEPARTMENT <br /> SAN <br /> A JOA <br /> -----._-CC)U'NTY...__ <br /> SITE APPROVAL/USE PERMIT <br /> FILE NUMBER: <br /> Water <br /> ..Service Provider Will Serve Letter Provided <br /> Public::, : 0 Distance to <br /> r ADJACENT STREET <br /> Country.Servlce Area 31 ❑: Public Water: <br /> Existing Well New Well' Well Replacement <br /> Private:' 171 - <br /> _. <br /> Wastewater Disposal <br /> ❑ Service Provider: Will Serve Letter Provided Distance to <br /> Public p <br /> Country Service Area 31 Public Sewer: ADJACENT STREET. <br /> ❑ Existing Septic System, New Septic System' Septic System Repli^cement:: <br /> Private . <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'c <br /> ■ Service Provider: Will Serve Letter Provided Distance to <br /> Public ❑ /� Public Storm <br /> Area 31 ADJACENT STREET <br /> County Service A <br /> Drain:. . . <br /> Existing n-site Retention Pond NewOn-site Retention Pond ra rainage <br /> Private <br /> El <br /> Other Public Services <br /> School Service Fire Protection Service <br /> ervice Frovider Distance to Service Provider- Distance to <br /> Lodi School: 74mi Woodbridge-Rural Co Fire Station: <800 ft <br /> Page 3 of 6 <br /> 08/1312021 <br />