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,--, TZ ' APPLICATION - LOT LINE ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT FILE NUMBER: 4�FNa'. r!ft..} Parcel Number Existing or Proposed Use of Parcel Existing Square Proposed Square I Footage or Acreage Footage or Acreage 1 Agriculture with residence 40,00 acres 2 Agriculture with residence 9.03 acres 1 liSM i Public Water Proposed❑ Existing Service Provider Annex-Formation Required Distance to Public Water(Feet)'^ X Mutual Water Company No. 3 No existing service Private Water X 1 Existing Well X New Well ❑ Well Replacement ❑ { k ARM. " Public Sewage Disposal Service Provider Annex-Formation Required Distance to Public Sewer Facility Proposed❑ Existing i - f ❑ I f On-site Sewage Disposal X 1 Existing Septic System X New Septic System ❑ Other❑ . ._ .. � Public Storm nn Aex-Formation Drainage Service Provider(if Public) Required Terminal Drainage to: Detention-Retention Ponds Proposed❑Existing ❑ R Private Storm Drainage X ) On-site Retention Ponds) 11 Natural Drainage/No Change X Other❑ Na a �.e. Y �t --WOW Nd 3� Service Provider . Distance to Service Service Provider Distance to Service PG&E r existing SBC existing . p p� Service Provider Distance to Service Service Provider Distance to Service Tracy Unified 4.5 miles Tracy Rural 4 miles Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks Delta Avenue 60! 28' (estimate) Yes❑ No X Yes o No X Yes❑ No❑ Yes❑ No❑ `-��'a,Pwi.. &Y[.:«-ig 89 �� h. 0.fi1.' T. v ,�&%. ,_:•.... S�Y^3Si ..x+.P' Road/Street Name R.O-W.Width Pavement Width Curb/Gutter Sidewalks N/A Yes❑ No n Yes o No❑ i Yes❑ No❑ Yes❑ No❑ F:DEVSVC/Planning Application Forms/ Lot Line Adjustment doe. (Revised i06-04-04) Page 2 of 3 Job No 2005-111