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SAN 1 O1Q U 11� COMMUNITY DEVELOPMENT DEPARTMENT <br /> —COUNTY-- SITE APPROVALIUSE PERMIT <br /> Greniness <br /> FILE NUMBER: <br /> SERVICES <br /> Water <br /> Public ❑ Service Provider: Will Serve Letter Provided Distance to <br /> ❑ Public Water: <br /> Existing Well New Well Well Replacement <br /> Private ■ <br /> a ❑ ❑ <br /> Wastewater Disposal <br /> Public ElService Provider: Will Serve Letter Provided Distance to <br /> ❑ Public Sewer: <br /> Private <br /> ❑ Existing Septic System New Septic System Septic System Replacement <br /> ❑ 0 ❑ <br /> Description of process wastewater: Volume of process Method of disposal: <br /> If the project will result in wastewater: <br /> process wastewater provide <br /> the following information: <br /> Storm Drainage <br /> Service Provider: Will Serve Letter Provided Distance to <br /> Public <br /> El Public Storm <br /> Drain: <br /> Existing On-site Retention Pond New On-site Retention Pond Natural Drainage <br /> Private Q <br /> ❑ F�] ❑ <br /> Other Public Services <br /> School Service Fire Protection Service <br /> Service Provider Distance to Service Provider Distance to <br /> • School: Fire Station: <br /> Page 3 of 6 <br /> 08113!2021 <br />