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i <br /> I- E 174 DIZI1 <br /> ; i?ATR <br /> Public Water Service Provider: Annexation or Formation Distance to Public W ate(t) <br /> Required? <br /> Existing ❑ <br /> Ptd ❑ Yes ❑ No Cl <br /> Private Water. X Existing Well ® New Well ❑ Other. <br /> WAGE:.I3I5PDSL . . <br /> st bR"- <br /> Public Sewage Disposal Service Provider. Annexation or Formation Distance to Public Sewer <br /> Required? Facility(miles) <br /> Existing ❑ <br /> Proposed ❑ Yes Cl N.❑ <br /> On-Site Sewage Disposal:X Existing Septic System ® New Septic System ❑ Other. <br /> hTO.Rt1 DRTNGE <br /> Public Storm Drainage Service Provider: Annex or Formation Terminal Drainage to: Detemicn- <br /> Required? Retenticn Posmas? <br /> Existing ❑ Yes Cl <br /> Proposed ❑ Yes❑ 'lo C3 <br /> Private Storm <br /> I Drainage: X On-site Retention Pond(s) ® Natural DrainagerNo Change ❑ other. - <br /> fLCr�iC TESxQ »svic <br /> Service Provider: Distance to Service: Service Provider: Distance to Service: --- <br /> P.G.&E. Adj acerit SBC Adl acent_ <br /> SXRVz <br />� District <br /> Lodi Unif i ed Distance to School Service Provider Dist-to Fre Station <br /> ElementaryLive a mi7 a Lodi. 3 males <br /> High School: Tokay 3 miles <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Cutter Sidewalks <br /> p Morse Rd. 40' 18' Yes❑ No© Yes❑ No <br /> Highway 99 Frontage 40' 27' Yes❑ No[ Yes❑ No <br /> Cora Post 40' & 50' 20' X X <br /> r <br />