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APPLICATION — DEVIATION <br />SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br />FILE NUMBER: DV - <br />FADEVSMPlanning Application ForrnsTeviation.doc. (Revised 5-11-09) Page 2 of 3 2018-117 Deviation <br />SITE IMPROVEMENTS AND SERVICES <br />Water <br />Public Water <br />Service Provider <br />Annex -Formation <br />Re uired <br />Distance to Public <br />Water Feet <br />Proposed ❑ <br />Existing ❑ <br />Private Water ® <br />Existing Well ® New Well ❑ Well Re lacement ❑ <br />Sewage Disposal <br />Public Sewage <br />Disposal <br />Service Provider <br />Annex -Formation <br />=red <br />Distance to Public <br />Sewer Facility <br />Proposed ❑ <br />Existing ❑ <br />On-site Sewage <br />Disposal ® <br />Existing Septic System ® New Septic System ❑ Other ❑ <br />Stone Drainage <br />Public Storm <br />Drainage <br />Proposed ❑ <br />.Service Provider (if Public) <br />Annex -Formation <br />Required <br />Terminal Drainage <br />to: <br />Detention -Retention <br />Ponds <br />Existing ❑ <br />Private Storm <br />Drainage ® <br />On-site Retention Pond(s) ❑ Natural Drainage/No Change ® Other ❑ <br />Electricity <br />Telephone Service <br />Service Provider <br />Distance to <br />Service <br />Service Provider <br />Distance to Service <br />PG&E <br />Existing <br />Frontier <br />Existing <br />School Service <br />Fire Protection Service <br />Service Provider <br />Distance to Elem School <br />Service Provider <br />Distance to Fire Station <br />Ripon Unified <br />1 Mile <br />Ripon <br />2.5 Miles <br />Existinig Roads <br />Road/Street Name <br />R.O.W. Width <br />Pavement Width <br />Curb/Gutter <br />Sidewalks <br />Jack Tone Road <br />80' <br />26' (Estimate) <br />Yes ❑ No ® <br />Yes ❑ No <br />Yes ❑ No ❑ <br />Yes ❑ No ❑ <br />FADEVSMPlanning Application ForrnsTeviation.doc. (Revised 5-11-09) Page 2 of 3 2018-117 Deviation <br />