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'°P c PLAN MAP AMENDMENT <br /> a� <br /> :< SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> �'• FILE NUMBER: - <br /> S�%F ORS P <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Proposed ❑ Re uired Water Feet <br /> Existin2❑ <br /> Private Water® Existing Well New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Oublic <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed ❑ <br /> Existin ❑ <br /> On-site Sewage <br /> Disposal® Existing Septic System ki New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed ❑ Required to: Ponds <br /> Existing❑ <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 /> PG&E at site PAC BELL at site <br /> School Service Fire Protection Service <br /> Service Provider Distance to Elem <br /> School Service Provider Distance to Fire Station <br /> ntezuma 1 1 2 mi Montezuma 1 3/4 mi <br /> Existing Roads <br /> Road/Street Name <br /> R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Mariposa Road unknown 50 ' Yes ❑ No [2 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 /> None <br /> Describe the current depth of the ground water and depth to potable water: <br /> Approximately 80-85 feet <br /> Describe any existing drainage courses or eroded areas on or near the project site (e.g. rivers,creeks,swales or drainage ditches): <br /> N A <br /> F:\DEVSVC\Plannmg Application Forms\ Page 5 of 7 <br /> Plan Application Amendment.doc.(Revised 6-03-04) <br />