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LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ft <br /> Parcel Number Exlstln or Proposed Use of Parcel� � � � - ���� � <br /> g pos Existing Proposed <br /> Square Footage Square Footage or <br /> orAcreage Acreage <br /> V75-t-7 o.=( iy <br /> nr <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Existing❑ Required Water{Feet)— <br /> Proposed, Y " A- <br /> —Privaats Water❑ Existing Well ❑ New Well ❑ Well Replacement ❑ <br /> 04 <br /> ra <br /> x s r or <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal Required Sewer Facility <br /> Existing❑ <br /> Proposed. <br /> On-site Sewage Existing Septic System ❑ New Septic System ❑ Other ❑ <br /> Disposal❑ <br /> nix <br /> Public Stam Service Provider Annex-Formation Terminal Drainage Detention- <br /> Drainage Required to: Retention Ponds <br /> Existing❑ <br /> Proposed❑ <br /> Private Storm On-site Retention Pond(s)❑ Natural DralnageQHo Change j9' - Other ❑ <br /> Drainage❑ <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> 0 -Vit <br /> Service Provider Distance to Service Service Provider Distance to Service <br /> 3 a. , <br /> -f' <br /> NO j <br /> Service Provider Distance to Elenr Service Provider Distance to Fire <br /> School Station <br /> S 5 D yq M i� <br /> { <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No kr Yes❑ No.? <br /> Yes❑ No❑ Yes❑ No <br /> RN <br /> Road/Street Name R.O.W.Width Pavement Width curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> io-osu �.uyse Fouwnr t,+e90 <br /> —3— <br />