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ope�,N APPLICA7TON — DEVIATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> r4tta.AH�s FILE NUMBER: DV- <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Proposed ❑ Rectuired Water Feet <br /> Existing❑ <br /> Private Water Existing Well New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required <br /> Proposed r_1 Sewer Facilit <br /> Existin ❑ <br /> On-site Sewage <br /> Disposal Existing Septic System ® New Septic Systerr) ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ Required to: Ponds <br /> Existing 1.3 <br /> Private Storm <br /> Draina e❑ On-site Retention Pond(s) ❑ Natural Drainage/No Change �4 Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider <br /> Distance to Service <br /> School Service Fire Protection Service <br /> Service Provider Distance to Elam <br /> School Service Provider Distance to Fire Station <br /> �-..ODI UtJtfre� W hTEt2.L00 1'1O�A <br /> Existin Roads <br /> Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks <br /> E ' \,j4LL 4FRp' Yes ❑ No ❑ Yes❑ Na ❑ <br /> Yes ❑ No ❑ Yes ❑ No ❑ <br /> F UEVSVC0anning Application FoonstDeviation.doc.(Revised 7.8-03) Page 3 of 6 <br />