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APPLICATION - DEVIATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> '•�!c FILE NUMBER: DV- <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed ❑ NIA N/A NIA <br /> Existing71 <br /> Private Water® Existin 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 ❑ N/A N/A N/A <br /> Existing ❑ <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 to: Detention-Retention <br /> Proposed ❑ <br /> Required Ponds <br /> Existing ❑ NIA N/A N/A N/A <br /> Private Storm <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 /> Pacific Gas&Electric 20 Feet SBC 20 Feet <br /> School Service Fire Protection Service <br /> Service Provider Distance to Elem Service Provider Distance to Fire Station <br /> School <br /> r:E:scalon School District 1.5 Mlles Escalon Fire District 1.5 Miles <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Mahon Road 40 Feet 22 Feet Yes❑ No ® Yes❑ No <br /> Yes ❑ No ❑ Yes❑ No❑ <br /> PTEVSVCnanning Application Fo ms0eviationAm.(Revised&03-04) Page 3 of 6 <br />