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APPLICATION- MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> PROPOSED PARCELS <br /> LEO Existing or Proposed Use o/Parcel Square Footage <br /> p orAcrea e <br /> /1l f'1 <br /> ,� Y <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Public Water Service Provider Annex-Formatlon Distance to Public Water(Feet) <br /> Existing o Required <br /> Proposed o <br /> Private Wate Existing Well o New Well Well Replacement o <br /> Sewage Dis osal <br /> Public Sewage Service Provider Annex-Formation Distance to Public Sewer <br /> Disposal Required Facility <br /> Existing o <br /> Proposed o <br /> On-site Sewa a Existing Septic System o New Septic System o Other <br /> Disposa <br /> Storm Drainage <br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detention-Retention Ponds <br /> Drainage Required to: <br /> Existing o <br /> Proposed o <br /> Private Storm On-si(e Retention Pond(s)) Natural Drainage/No Change o Other o <br /> Drainage o <br /> Electricit 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 /> School Service Fire Protection Service <br /> Service Provider Distance to Elem Service Provider Distance to Fire Station <br /> School <br /> /V, % � <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutfer Sidewalks <br /> Rd �O / 3 Z Yes o NOX Yes o No< <br /> Yes o No o Yes o No o <br /> Proposed Roads <br /> Road/S(reet Name R.O.W.Width Pavement Width Curb/Gut(er Sidewalks <br /> Yes o No o Yes o No o <br /> Yes o No o Yes o No o <br /> 3- <br />