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°Aa�,N..o PLAN MAP AMENDMENT <br /> �0 <br /> N <' SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> \• c. ` P/ FILE NUMBER: - - <br /> ��IFOR�` <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed ❑ 5 <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 Sewer Facility <br /> Proposed d <br /> Existin �'���Ct' �,� t; �c' Vii' L/:. <br /> On-site Sewage <br /> Disposal ❑ Existing Septic System ❑ New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ <br /> Required to: Ponds <br /> Existing ❑ �'t-IC'Z�' 6'' �� <br /> Private Storm <br /> Drainage❑ I On-site Retention Pond(s) ❑ Natural Drainage/No Change ❑ Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> _ T <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Se ce Provider School Service Provider Distance to Fire Station <br /> It, Te <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> 1 <br /> � , ��• .�� Yes❑- No❑ Yes[3.,/No❑ <br /> .- Yes❑' No❑ Yes Q'No ❑ <br /> ENVIRONMENTAL INFORMATION <br /> USE ADDITIONAL PAPER, IF NECESSARY <br /> Water, Drainage and Flooding <br /> Describe any areas subject to flooding (include flood depths and flood panel map number): <br /> Describe the current depth of the ground water and depth to potable water: <br /> Describe any existing drainage courses or eroded areas on or near the project site(e.g. rivers, creeks,swales or drainage ditches): <br /> F:\DEVSVC\Planning Application Forms\ Page 6 of 8 <br /> Plan Application Amendment.doc.(Revised 05-11-09 <br />