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4u�N Z APPLICATION - ZONE RECLASSIFICATION � <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NO: ZR- <br /> �/FORS I <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water❑ Service Provider Required Water Feet <br /> FPrivate Water Existing Well ©' New Well ❑ Well Re lacement ❑ <br /> Sewage Disposal <br /> Annex-Formation Distance to Public <br /> Public Sewage Service Provider <br /> Disposal Required Sewer Facility <br /> ❑ <br /> i <br /> On-site��Sewage��Dispo­salEl Existin Septic System ❑ New Septic System Other ❑ <br /> Storm Drainage <br /> Annex-Formation Terminal Detention- <br /> Public Storm Service Provider Required Draina e to: Retention Ponds <br /> Drainage ❑ <br /> [Private Storm Drainage On-site Retention Ponds Natural Drainage/No Chane ❑ Other ❑ <br /> Electricity Natural Gas <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> ;DC- oitJ S <br /> Telephone Service Cable Television Service <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> � OA) ��r- <br /> School Service Fire Protection Service <br /> Distance to Elem. Distance to Fire <br /> Service Provider School Service Provider Station <br /> Existing Roads <br /> ¢� Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes ❑ No ❑ Yes ❑ No El- <br /> Yes <br /> Yes ❑ No ❑ Yes ❑ No ❑ <br /> F:\DEVSVS\Planning Application Forms2ONE RECLASSIFICATION Page 3 of 5 <br /> (Rev.6-02-04) <br />