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APPLICATION- SITE APPROVAL <br /> PRIVATE RIGHT OF WAY- ANTIQUATED SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> y <br /> 2, <br /> m' b; <br /> - ti's-�^ <,,{ ,']= 3`�rSITE/MPI20VEMENT�SAIVD�SERVICES✓ ,+"",x5��„.ry ,�el,'�q<�1�51 +�;� <br /> »n M <br /> h.'W 45 <br /> Public Water Service Provider Annex-Formation Dbbne.fo PubNc Wsl.r <br /> Proposed❑ Required <br /> Existing❑ <br /> Pnvate Water Existing Well ❑ New Well Well Replacement ❑ <br /> �. Sewa a Dis osa/ res a �r ar <br /> r�-v pdwt✓,^'ir`^.*.k. `�N'_' <br /> Service Provider Annex-Formation oral.,,..e.Public s..0 <br /> Public Sewage Requited P'c'llty <br /> Disposal <br /> Proposed❑ <br /> Existing❑ <br /> On-s/ta Sewage Existing Septic System ❑ New Septic System Other ❑ <br /> Disposal <br /> t , E <br /> V , A. . « St <br /> on aaa+'na9 <br /> . <br /> Public Storm Service Provider(it Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Drainage Required to: Ponds <br /> Proposed❑ <br /> Existing O <br /> Private Storm On-site Retention Pond(s) ❑ Natural Drainage/No Changed Other ❑ <br /> Drainage❑ <br /> I•@I110A9 S9/Y1C :(iti'.: <br /> „Elect/lcttyxtr,, Pn� <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> ... f"�n ^qi .W3�4" '�li$�.M{ iM1Ff,1 vr.":rtMl ♦.Ya.i.f'�w Y ..��:T?iK SeryicYe <br /> je- /e <br /> S <br /> 0w01Selvice't. V !# emce ..t <br /> .' <br /> Service Provider Distance to Elem Service Provider Distance to Fire <br /> School Station <br /> A�Existing Roads 4 .,: •.. €,: .-. Ja, s <br /> Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No N Yes❑ N <br /> Yes❑ No O Yes❑ No❑ <br /> -3- <br />