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°P APi-LICATION - SPECIAL PURPOSE PLAN <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: SP- <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed❑ <br /> Existing ❑ S ffs <br /> Private Water❑ Existing Well ❑ New Well ❑ Well Replacement ❑ <br /> _ Sewage Disposal. _ <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed❑ <br /> Existing ❑ CS <br /> On-site Sewage <br /> Disposal ❑ Existing Septic System ❑ New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ I Required to: Ponds <br /> Existing ❑ C S A 3 <br /> Private Storm <br /> Drainage❑ On-site Retention Ponds ❑ Natural Drainage/No Chane ❑ Other ❑ <br /> Electricity Telephone Service <br /> Distance to - <br /> Service Provider Service Service Provider Distance to Service <br /> School Service T Fire Protection Service <br /> Distance to Elem <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 /> Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> ENVIRONMENTAL INFORMATION <br /> USE ADDITIONAL PAPER IF NECESSARY <br /> Water, Drainage and Flooding <br /> Describe any areas subject to flooding(include flood depths and flood panel map number): <br /> Describe the current depth of the ground water and depth to potable water: <br /> Describe any existing drainage courses or eroded areas on or near the project site(e.g. rivers, creeks,swales or drainage ditches): <br /> FADEVSMPlanning Application FomsVAgdcultural Preserve-doc. Page 4 of 5 <br /> (Revised 8-10-05) <br />