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APPLICA , ON - VARIANCE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> SITE IMPROVEMENTS AND SERVICES <br /> Wader <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water Required Water(Feet) <br /> Existing ❑ <br /> Proposed ❑ <br /> Private sting Well p New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal Required Sewer Facility <br /> Existing ❑ <br /> Proposed ❑ I-AHQt't) i <br /> (uw4lil w,aTfr, aL)6a r, a-� rmouai on Pet,lir Na,eS <br /> On-site Sewage Existing Septic System (Y New Septic System ❑ Other 11Disposal❑ <br /> IF <br /> Storm Drainage <br /> Public Stonn Service Provider(if Public) Annex-Fortnafion Terminal Drainage Detention- <br /> Drainage Required to: Retention Ponds <br /> Existing ❑ <br /> Proposed ❑ <br /> Private St On-site Pefention Pond(s) ❑ Natural DminageJNo Change Other L1Drainage <br /> Electricity Telephone Service <br /> Service Provider Distance to Service Provider Distance to <br /> Service Service <br /> n G & E cern Iii tC-'PF�- 8'i lue <br /> School Service Fire Protection Service <br /> Service Provider Distance to Elem Service Provider Distance to Fire <br /> School Station <br /> Existing Roads <br /> Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks <br /> Mc 110 ��[� I � t � Yes❑ No 6X Yes❑ No <br /> Yes❑ No❑ Yes❑ No❑ <br /> 3- <br />