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APOLICATION - ZONE R&LASSIFICATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> V <br /> i�• .:...:..moi:' <br /> Service Provider Annex-Formation Distance to Public <br /> Public Water❑ Required Water(Feet) <br /> Private Water Existing Well New Well ❑ Well Replacement ❑ <br /> ;:: Sewage DfspasaE .X. <br /> : <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal❑ Required Sewer Facility <br /> On-site Sewage Existing Septic System New Septic System ] Other ❑ <br /> Disposal <br /> ' Storm Drelnege ` <br /> Public Storm Service Provider M Public) Annex-Formation Terminal Drainage Detention- <br /> Drainage❑ Required to: Retention Ponds <br /> Private Storm On-site Retention Pond(s) ❑ Natural Drainage/No Change Other ❑ <br /> Drainage <br /> Electrictt <br /> ;: >:<: Service< '. <br /> Service Provider Distance to Service Service Provider Distance to <br /> Service <br /> PIaE SO/o99 o',_1 I—' T�LED.UOAJE Sd-/Do' <br /> :. .... SChoo[S9L1rtCe Fire Protection Service <br /> Service Provider Distance to Elem Service Provider Distance to Fire <br /> School Station <br /> P/V,e^•IO cv/V 1//L-7-4 <br /> ExistinRo <br /> g ads <br /> Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks <br /> fl20it M*41 5' IZ.D 99 Yes❑ Nox Yes ❑ NoX <br /> 17)1}O I A05)0_ ,Q,D Yes❑ Nox Yes ❑ NoN6 <br /> } -3- <br />