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SAN 10AQUIN <br />COUNTY <br />Greotn ss grows f er <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />SERVICES <br />SITE APPROVALMSE PERMIT <br />FILE NUMBER: <br />Water <br />School Service <br />Service Provider: <br />Will Serve Letter Provided <br />Distance to <br />School: <br />I <br />Public ❑ <br />Distance to <br />Fire Station: <br />Distance to <br />❑ <br />Public Water: <br />Existing Well <br />New Well <br />Well Replacement <br />Private ❑ <br />❑ <br />❑ <br />❑ <br />Wastewater Disposal <br />Service Provider: <br />Will Serve Letter Provided <br />Public ❑ <br />Distance to <br />❑ <br />Public Sewer: <br />Existing Septic System <br />New Septic System <br />Septic System Replacement <br />Private ❑■ <br />❑ <br />❑ <br />❑ <br />Description of process wastewater: <br />Volume of process <br />Method of disposal: <br />If the project will result in <br />wastewater: <br />process wastewater provide <br />the following information: <br />Storm <br />Drainage <br />Service Provider: <br />Will Serve Letter Provided <br />Distance to <br />Public ❑ <br />❑ <br />Public Storm <br />Drain: <br />Existing On-site Retention Pond <br />New On-site Retention Pond <br />Natural Drainage <br />Private <br />❑ <br />❑ <br />❑ <br />Other Public Services <br />School Service <br />Fire Protection Service <br />Service Provider <br />Distance to <br />School: <br />I <br />Service Provider <br />Distance to <br />Fire Station: <br />Page 3 of 6 <br />08/13/2021 <br />