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opa �N. APPLICATION SITE APPROVAL <br /> S:— PR's.. ATE RIGHT 0 WAY — ANI ,4UATED SUBDIVISION <br /> SAN JOAQUIN.COUNTY-COMMUNITY DEVELOPMENT DEPARTMENT <br /> • �q...... �P• FILE NUMBER: SA- <br /> ��ROR - - <br /> xsllr rnIErs '► 1 sER�rcIS s a <br /> Annex Formation t< Distance to Public <br /> Public Water Re uired Water Feet <br /> r Service Rroiiider <br /> t Proposed❑ _ . <br /> F <br /> Existing ❑ <br /> Private Watery, <br /> ater Existing Well..❑ New Well Well Replacement ❑ <br /> I ,. � + _n ',y fS@'IrVafJezUI�pOSaI t <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider., ; <br /> Proposed Required Sewer Facie <br /> ❑ <br /> ty <br /> Existin ❑ <br /> On-site Sewage <br /> Disposal 9 1 Existing:Septic System .❑. New Septic System Other ❑ <br /> a 5'torrn�Cl�aririage <br /> i Public Storm <br /> i Drainage Service Provider(it Public) Annex-Formation Terminal Drainage . Detention-Retention <br /> Proposed ❑ Required to: Ponds <br /> Existing ElJ <br /> { J[ Private Stoff <br /> Drainage 7 On-site Retention Pond s ❑ Natural Drainage/No Chane Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> School Service Fire Protection Service <br /> i Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> Mok u � ztfL 0A <br /> Existing itoads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> f vt S C /U sd f NOMI Yes ❑ No Yes ❑ No <br /> N O T Yes ❑ No ❑ Yes ❑ No ❑ <br /> i F,IDEVSVC\PIanning Application F-orms%Site Approval} Page.3 of 7 <br /> 1 private Right of Way.(Revised4-2-63 <br /> i <br /> _T: ' <br />