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COMMUNITY DEVELOPMENT DEPARTMENT <br /> � = f SAN JOAQUIN <br /> i <br /> WAIVER; `_: : _ COUNTY <br /> FILE NUMBER : <br /> SERVICES <br /> Water <br /> Public Service Provider: Will Serve Letter Provided Distance to Public Water: <br /> ❑ ❑ <br /> Private Existing ell New Well Well Replacement <br /> ❑ ❑ ❑ <br /> Wastewater Disposal <br /> Public Service Provider : Will Serve Letter Provided Distance to Public Sewer : <br /> El El <br /> Private Existing Septi System New Septic System Septic System Replacement <br /> ❑ ❑ ❑ <br /> Description of process Volume of process wastewater: Method of disposal : <br /> If the project will result in process wastewater: <br /> wastewater provide the following <br /> information : <br /> Storm Drainage <br /> Public Service Provider: Will Serve Letter Provided Distance to Public Storm Drain : <br /> Private Existing On -site Retention Pond New On -site Retention Pond Natural Drai age <br /> ❑ ❑ ❑ <br /> OTHER PUBLIC SERVICES <br /> School Service Fire Protection Service <br /> Service Providg.,rDistance to School Service Provider Distance to Fire Station <br /> Existing Roads <br /> Road /Street Name R . O . W . Width Pavement Width Curb /Gutter Sidewalks <br /> Yes No ❑ Yes [/No ❑ <br /> Yes E4o ❑ Yes ZNo ❑ <br /> Page 2 of 5 <br /> 10/31 /2023 <br />