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APPLICATION- SITE APPROVAL
<br /> PRIVATE RIGHT OF WAY - ANTIQUATED SUBDIVISION
<br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
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<br /> Public Water Service Provides Mnex-Formation Distance to
<br /> Proposed❑ Required Public Water
<br /> Existing❑ (Feet)
<br /> Private Water Existing Well NOW Weil ❑ Well Replacement ❑
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<br /> Public Sewage Service Provider Annex-Formation Distance to
<br /> Disposal Required Public Sewer
<br /> Proposed❑
<br /> Facility
<br /> Existing❑
<br /> On-she Sewage Existing Septic System New Septic System ❑ Other ❑
<br /> Disposal b
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<br /> Public Storm Service Provider(it Public) Annex-Formation Tern*W Drainage Detention-
<br /> Drainage Required to: Retention Ponds
<br /> Proposed❑
<br /> Existing❑
<br /> Private Storm On-she Retention Ponds) Natural Drainage/No Change ❑ Other ❑
<br /> Drainageq
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<br /> Service Provider Distance to Service Provider Distance to
<br /> Service Service
<br /> Existing - PG&E on site existing on site
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<br /> Service Provider Distance to Eleni Service Provider Distance to Fire
<br /> School Station
<br /> efferson School ,K-8 @ linne & Chril3tman Station #4 1 mile
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<br /> Road/Street Name R.O.W.Width Pavement Wldth Curb/Gutter Sidewalks
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<br /> Yes❑ No❑ Yes❑ No❑
<br /> -3-
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