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09/16/2008 12: 03 FAX 2094683 UC_COMM_6EV Z006/006 <br /> CITY OF STOCKTON Sewer/1Nater Service Application <br /> Municipal Utilities Department Outside City Limits <br /> Assessor Parcel Number: Address of Parcel: <br /> Applicant's Name: Phone:( 1 <br /> Address: Date,: <br /> Present Use: Proposed Use: <br /> Residential Number of Units Residential Number of Units <br /> Commercial Commerclal <br /> industrial _Industrial <br /> Undeveloped ____Other: _ <br /> Other: <br /> Status of County approval: <br /> 1. Community Development Department General Plan Designation <br /> Compiles with City General Plan <br /> Does not comply with City General Plan <br /> Require annexation to the City of Stockton <br /> Require applicant to enter into a Conditional Utility Service Agreement <br /> JAMES E. GLASER, DIRECTOR <br /> COMMUNITY DEVELOPMENT DEPARTMENT <br /> BY: _ Date: <br /> 2. Public Works Department <br /> A. Area of Benefit(Other Fees <br /> B. CFD 90-1 Fees <br /> JAMES B. GIOTTONINI, PUBLIC WORKS DIRECTOR <br /> BY: _ Date: <br /> 3. Municipal Utilities Department <br /> A. Connection Fee $ <br /> B. Other Requirements <br /> C. Sewer Service <br /> Approved <br /> Approved, subject to: <br /> Not Approved <br /> MARK J. MADISON, MUNICIPAL UTILITIES DIRECTOR <br /> 8Y: _ Date: <br /> 4. To Permit Center for collection of fees and issuance of Permit. <br /> Distribution: Original to applicant <br /> Copies to: Municipal Utilities, Public Works, Community Development, Finance, County Building <br />