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°A41`" c <br /> PLAN MAP AMENDMENT <br /> �:• . o <br /> {' SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> . e, <br /> P/ FILE NUMBER: - - <br /> 4<i�oa�% <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed [:] <br /> Existing P` � 0 <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 ❑ <br /> z <br /> Existing❑ L t G Lt,l ,� t �' �< <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 ❑ 11LlCt t <br /> Private Storm ' <br /> Drainage❑ 1 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 /> L t t — ; Au tk',I c: <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Se ice 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 /> ,) 1 �� Yes❑- No❑ Yes❑" No❑ <br /> Yes 0' No❑ Yes ❑ 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 />