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Lt. ,SINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 12} <br /> Parcel Number Existing or Proposed Use of Parcel Existing Proposed <br /> Square Footage Square Footage <br /> f or Acreage orAcreage <br /> V <br /> Y <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Existing❑ Required Water(Feet) <br /> Proposed❑ <br /> Private Water Existing Wel! New Well ❑ Well Replacement ❑ <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Required Sewer Facility <br /> Disposal q Y <br /> Existing❑ <br /> Proposed❑ <br /> On-site Sew a Existing Septic System New Septic System 13Other 13 <br /> Disposal <br /> to nro <br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detentlon- <br /> Drainage Required to: Retention Ponds <br /> Existing❑ <br /> Proposed Q <br /> i <br /> i <br /> Private Storm On-site Retention Pond(s)❑ Natural DrainageflHo Change Other ❑ <br /> Drainage❑ <br /> ,,�� , <br /> ria' dR <br /> ' <br /> Service Provider Distance to Service Provider Distance to j <br /> Service Service <br /> �1 : :�- . �'" t. , ta• :' �� . r�,�:r,- .;,.,,t Cabie;Teievlslott•5ervlce)'4� r,. .r�1��' , ` ..�;�< <br /> Service Provider Distance to Service Provider Distance to <br /> Service Service <br /> {'f y:.F�,Y s�[,',+:� r .P M + �+.'", ;��i""y^I.?�y;'°r�• w" � � <br /> on R 11 <br /> i" r t3F+ s R�•.;�:a' �.� � 2 it{ac ,..,� u a_., ,.- s rg"tr.:';�:'4^4s ��P°Y�°�'�.+g��' f� ' y¢"+`,��V. <br /> ew vhs � r reProteCBSUrYIc11d <br /> Service Provider Distance to Elem Service Provider Distance to Fire <br /> Schon! Station <br /> d /{ 41/ f. <br /> �y .', <br /> gC�lbt f�8{��'# d� { 5k�.i�w �zr� `-M V' , f .. <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> z Yes❑ Nof Yes❑ No <br /> Yes O❑_ .,Yes - No^o 0 <br /> p r, <br /> Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> -.1 PMPA_E,A06 Febuary 1,1000 <br /> °y,4 <br />