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i <br /> - • ° PLAk4AP AMENDMENT <br /> :< SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> c� FILE NUMBER. - <br />' <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed❑ <br /> Existin ❑ <br /> Private Water❑ Existing Well New Well Well Replacement <br /> ❑ ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Re uired Sewer Facility <br /> Proposed❑ <br /> Existing❑ <br /> On-site Sewage <br /> Disposal❑ Existing Septic Syst New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Ann <br /> Drainage Service Provider{if Public) ex-Formation Terminal Drainage Detention-Retention <br /> Proposed ElRequired to: Ponds <br /> Existing❑ <br /> Private Storrp <br /> I <br /> Drainage On-site Retention Pond(s) Natural Drainage/No Change ❑ Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> School Service Fire Protection Service <br /> Distance to E1em <br /> Service Provider School Service Provider Distance to Fire Station <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Rd AS ilA Yes❑ No Fie' Yes ❑ No <br /> Yes❑ No❑ Yes❑ No❑ <br /> 1=NVIRONMENTAL INFORMATION <br /> USE ADDITIONAL PAPER, IF NECESSARY) <br /> Water, Drainage and Flooding <br /> Describ areas subject to flooding(include flood depths and flood panel map r : <br /> Describe the current depth of the ground wa depth to potable water: <br /> Describe any exi ' drainage courses or eroded areas on or near the project site(e.g. rivers, creeks, sw rainage ditches): <br /> FADI"VSVCIPlanning Application Formsl Page 5 of 7 <br /> Plan Applicatlon Amendment.doc.(Revised 11-05-07 <br />