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o�aUt� c ��•���••°�{ PLAN AP AMENDMENT - <br /> SAN r <br /> r <br /> JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> MRA <br /> � v <br /> �& �"' <br /> �. '"i-+;il5 f�2 -- r 1k@ gaE c �_d. R ca ,J hs. `;s t3 >"• it � � ..ur�r ,9_ �3."�.���i �rt!�5� i�a7�`Y£� f����� �°., <br /> ip <br /> Public Water5ervioe Provider Annex-Formation Distance to Public <br /> Proposed❑ Re wired Water Feet <br /> Existin ❑ <br /> Private Water E—xisting Well ❑ New Wel! <br /> Well Replacement ❑ <br /> ^,x" T '� r: iu J!" `k.'y <br /> rqi$� 8 al y�' � �vtg`si't+-a- ry"�yj <br /> . _,. <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Re uired Sewer Facili <br /> Proposed❑ <br /> Existing❑ <br /> On-site Sewage <br /> Dis osal Existing Septic System E] New Septic Sys te Other ❑ <br /> - S`tarm��ralnaga;� s Y <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ Required to: Ponds <br /> Existing❑ <br /> Private Storm <br /> Drains a On-site Retention Pond(s) Natural DrainagelNo Change ❑ Other ❑ <br /> Electricity .. .` Telephone'Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> School Service. Fire Piatectlon Service. <br /> Service Provider Distance to Elem <br /> School Service Provider Distance to Fire Station <br /> Existing:Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> A—Wq R-a r►-T*6 i�-_ .a,) S D r 3.4.) , Yes❑ No`P Yes❑ No R. <br /> Yes❑ No❑ Yes❑ No❑ <br /> ENVIRONMENTAL INFORMATION <br /> USE ADDITIONAL PAPER, IF NECESSARY <br /> Water, Drainage and Flooding <br /> Describe any areas subject to flooding (include flood depths and flood panel map number): <br /> Describe the current depth of the ground water and depth to potable water: Sv <br /> Describe any existing drainage courses or eroded areas on or near the project site(e.g. rivers,creeks,swales or drainage ditches): <br /> F:IDEVSVC\Planning Application Formsl Page 5 of 7 <br /> Plan Application Amendment.doc.(Revised 6-03-04) <br />