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e <br /> oQu'N. APPLICATION — LOT LINE ADJUSTMENT <br /> Z•'' ctr--r . <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> PROPOSED PARCELS <br /> Parcel Number ExistingExisting Square Proposed Square <br /> or Proposed Use of Parcel Foota a or Acreage Foota a or Acreage <br /> �1 <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Public WaterAnnex-Formation Distance to Public <br /> Service Provider <br /> Proposed Required Water Feet <br /> ❑ <br /> -Existing❑ <br /> Private Wate Existing Well New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Re uired Sewer Facility <br /> Proposed ❑ <br /> Existing❑ <br /> i <br /> On-site Sewage <br /> Disposal Existing Septic System New Septic S stem ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed ❑ -Required to: Ponds <br /> Existing ❑ <br /> Private Storm <br /> Drainage❑ On-site Retention Ponds ❑ Natural Drainage/No Chane Other ❑ <br /> Electricity Telephone Service. <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> School Service Fire Protection Service -. <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> r Greer Yes❑ NoA Yes❑ No s�] <br /> c / f Yes❑ No Yes ❑ No,�T <br /> Pro osed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> FWEVSVCNPlanning Application Formsl Page 4 of 7 <br /> Lot Line Adjustment.doc.(Revised 6-4-04) <br />