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r' r — APPLICATION - LOT LINE ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT Parcel Number Existing or Proposed Use of Parcel Existing Proposed Square Footage Square Footage or Acreage or Acreage 005-142-19 lbe Well and Well-House for Parcel No. 005-142-02-1 is on Parcel 005-142-1 approx. a rox. 52,893.96 48,643.96 SITS JMPFi Y ME lTS AN'D'Sl=R1C#CES :...::::..::::.:.:.. :...::...... ..... ...-,. ,-':., - ........:..:..:�:...:...........::�::._.:�:::::::::._.:�:::<:•5>ii'i;' ii:; {i��tP,f:.5:'iisiii:ii<it+;:ii6 Service Provider Annex-Formation Distance to Public Public Water❑ Required Water (Feet) Both parcels have wells Private Water Existing Well IN New Well ❑ Well Replacement ❑ :.:.:...:::::.,:=Se►ua a Dis osal Public Sewage Service Provider Annex-Formation Distance to Public Disposal ❑ Required Sewer Facility On-site Sewage Existing Septic System New Septic System C1 Other ❑ DisposalXX ........ Public Storm Service Provider Annex-Formation Terminal Drainage Detention- Drainage❑ Required to: Retention Ponds Private Storm On-site Retention Pond(s) ❑ Natural Drainage/No Changed Other ❑ Drainage'W :....: Service Provider Distance to Service Service Provider Distance to Service Pacific Gas & Electric feet Pacific Gas & Electric feet 7slelhrta Senrica Cable Tcievision.Servilre Service Provider Distance to Service Service Provider Distance to Service Pagific Bell feet c. Service Pravider Distance to Elem Service Provider Distance to Fire School Station. Galt High School District 5-7 Miles Forest Lake Fire District % Mile . .:::.:...:......:.......::.�s�ing Roads:;:::::< :: Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks East Collier Road De s eo I� Yes ❑ No X North Hi hwa 99 Frontage Qs eNo❑ Yes❑ No IN F.... ........tflR sails Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks n/a Yes❑ No❑ Yes Q No❑ Yes 0 No 0 Yes❑ No 0