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APPLICATION- MINOR SUBDIVISION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> :PROPOSED PARCEL S <br /> Parcel Number Existing or Proposed Use of Parcel Square Footage <br /> or Acreage <br /> Sr IMPROVEMENT- S. Q:SERVICE,S <br /> Public Water Service Provider Annex-Formation Distance to Public Water <br /> Existingo Required (Feet) <br /> Proposed❑ <br /> A0 K v NE Z5 l-,lo v , <br /> Prtvate Water❑ Existing Well ❑ New Well ❑ Well Replacement ❑ <br /> Public Sewage Service Provider Annex-Formation Distance to Public Sewer <br /> Disposal Required Facility <br /> Existing(, <br /> Proposed❑ WOO / AA117-4 k /D/5rg/C7— <br /> On-site Sewage Existing Septic System ❑ New Septic System ❑ Other ❑ <br /> Disposal C <br /> Storm:Draina a <br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detention-Retention Ponds <br /> Drainage Required to: <br /> Existing <br /> Proposed C <br /> e)UAITYC l,J <br /> Private Storm I On-site Retention Pond(s) ❑ Natural DrainagelNo Change�, Other ❑ <br /> Orainaue C <br /> Electric.-ty Natural Gas <br /> I <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> -PG4 E <br /> Teleohone Service Cable Television Service <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> I <br /> (OO t MED1 Q g.IE ��r <br /> j School Service <br /> -- - "Fire Protection Service <br /> Service Provider Distance to ElamI Service Provider Distance to Fire Station <br /> l School 7 <br /> LAAoo.n Ez&Me<rrARy, LORA ,2.S M I I !Joon ,e u / <br /> Et <br /> F-xistinct Roads. <br /> Road/Street Name I R.O.W.Width I Pavement Width Curb/Gutter I Sidewalks <br /> i I Yes❑ Nox ( Yes❑ Nok <br /> O <br /> / r I Yes❑ Nog I Yes C NoX <br /> Pr000secf Roads: <br /> i <br /> Road/Street Name I R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> i <br /> Yes❑ No C Yes❑ No❑ <br />