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APPLIQ� 'ON - DEVIATION
<br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
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<br /> Service Provider Annex-Formation Distance to Public
<br /> Public Water Required Water(Feet)
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<br /> Private Water Existing Well ❑ New Well Well Replacement ❑
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<br /> Public Sewage Service Provider Annex-Formation Distance to Public
<br /> Disposal Required Sewer Facility
<br /> Existing ❑
<br /> Proposed ❑
<br /> Orratte a Existing Septic System ❑ New Septic System ¢( Other ❑
<br /> Disposal / -
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<br /> Public Storm Service Provider (H Public) Annex-Formation Terminal Drainage Detention-
<br /> Drainage Required to: Retention Ponds
<br /> Existing ❑
<br /> Proposed ❑
<br /> Private Storm On-site Retention Pond(s) Natural Drainage/No Change ❑ Other ❑
<br /> Drainage❑
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<br /> School / Station
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<br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks
<br /> 23o/ 3Z Yea❑ No Yea❑ No
<br /> Yes❑ No❑ Yes O No❑
<br /> .3-
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