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oP4 �"r•.,p APPLICATION OSITE APPROVA, L - <br /> �.•�•� •.oma <br /> z .y PRIVATE RIGHT OF WAY - ANTIQUATED SUBDIVISION <br /> " SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT.. <br /> FILE NUMBER: SA- <br /> cc <br /> A- <br /> r <br /> ,> Sl' E IMPROVEAA �T []S�ERy ICES ' 3 Y <br /> ater .'!': <br /> Annex=Formation Distance to P6blic . <br /> Public Water Service Provider Re uiC.ed; = W,ater Feet <br /> Proposed ❑ <br /> Existing❑ <br /> Private Wate"K Existing Well New Well ❑ Well`Rep lacement;0 . <br /> - <br /> Sewage:Dfis'piosal� <br /> Public Sewagt Annex-Formation Distance to Public <br /> Disposal Service Provider Re aired Sewer Facility <br /> Proposed ❑ <br /> Existin ❑ <br /> On-site Sewage r <br /> Dis2osalZ Existing Septic System ❑ New Septic System - Other 0;-:' <br /> Stor[n Drainage ' <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 /> Drainage On-site Retention Ponds ❑ Natural Draina a/No Chane Other ❑ <br /> Electricity Telephone lService <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> G U Yes❑ No Ef Yes❑ No <br /> Yes❑ No❑ Yes❑ No <br /> F:IDEVSVC\Planning Application Forms\Site Approval) Page 3 of 7 <br /> Private Right of Way.(Revised4-2-03 <br />