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L + <br /> APPLICATION --- ZONEECLASSIFICATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ' FILE NO: ZR- <br /> SITE IMPROVEMENTI.S AND SERVICES71. <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water❑ Service Provider Required Water(Feet) <br /> Private' Existi ng Well ❑ New Well Well Replacement ❑ <br /> Seirvage,bispasal <br /> Annex-Formation Distance to Public <br /> Public Sewage Service Provider <br /> Disposal[jRequired Sewer Facility <br /> 1 On-site Sewa e Disposalla, Existing Septic System ❑ New Septic System bg- Other ❑ <br /> Storm Drainage <br /> Annex-Formation Terminal Detention- <br /> Public Storm Service Provider Required Draina e to: Retention Ponds <br /> Drainage❑ <br /> Private Storm Drainage On-site Retention Ponds Natural Drainage/No Chane ❑ Other ❑ <br /> Electricity Natural Gas <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> Telephone Service Cable Television Service <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> r A-. <br /> School Service Fire Protection Service <br /> Distance to Elem. Distance to Fire <br /> Service Provider School Service Provider Station <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width —Curb/Gutter Sidewalks <br /> Yes ❑ No ❑ Yes ❑ No ❑ <br /> Yes ❑ No❑ Yes ❑ No ❑ <br /> F tDFVSVS\Planning Application rormslZONE RECLASSIFICATION Page 3 of 5 <br /> (Rev. 12-07-06) <br />