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APPLICATION - SITE APPROVAL <br />PRIVATE RIGHT OF WAY - ANTIQUATED SUBDIVISION <br />SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br />FILE NUMBER: SA - <br />F:\DEVSVC\Planning Application FonnsGSite Approval) Page 3 of 7 <br />Private Right of Way. (Revised4-2-03 <br />SITE IMPROVEMENTS AND SERVICES <br />_ Water <br />7LEfxirsting <br />Service Provider <br />Annex -Formation <br />Re uired <br />Distance to Public <br />Water Feet <br />Private Water <br />Existing Well ❑ New WellvL( Well Replacement ❑ <br />Sewage Disposal <br />Public Sewage <br />Disposal <br />Service Provider <br />Annex -Formation <br />Required <br />Distance to Public <br />Sewer Facility <br />Proposed ❑ <br />Existing ❑ <br />On-site Sewage <br />Dis osal QI <br />Existin Septic System ❑ New Septic System Other ❑ <br />Storm 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 Ponds ❑ Natural Drains e/No Chane Other ❑ <br />Electricity <br />Telephone Service <br />Service Provider <br />Distance to <br />Service <br />Service Provider <br />Distance to Service <br />fi <br />i <br />School Service <br />Fire Protection Service <br />Service Provider <br />Distance to Elem <br />School <br />Service Provider <br />Distance to Fire Station <br />e,o t Nirtct <br />MtL' <br />lWylexzCr2�L7- <br />tj tit= <br />Existin Roads <br />Road/Street Name <br />R.O.W. Width <br />Pavement Width <br />Curb/Gutter <br />Sidewalks <br />F4 t -I <br />r <br />t <br />Yes ❑ No 9 <br />Yes ❑ No K' <br />Yes ❑ No [[/ <br />Yes ❑ No [Z' <br />F:\DEVSVC\Planning Application FonnsGSite Approval) Page 3 of 7 <br />Private Right of Way. (Revised4-2-03 <br />