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a� ri APPLICATION - LOT LINE ADJUSTMENT <br /> r.•'' z SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> 9�iFORN <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existin or Prosed Use of Parcel Foota a or Acreage Footage or Acreage <br /> oo`_ ,\-r__ 74r,o A,--- <br /> 74 QHG t <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Re uired Water Feet <br /> Proposed❑ <br /> Existin ❑ <br /> Private Water❑ Existin2 Well New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> AnnLRequired <br /> Distance to Public <br /> Public Sewage Sewer Facility <br /> Disposal Service Provider <br /> Proposed❑ <br /> Existin ❑ <br /> On-site Sewage New Septic System ❑ Other ❑ <br /> Disposal❑ Existing Septic System <br /> Storm Drainage <br /> Public Storm Annex-Formation Terminal Drainage Detention-Retention <br /> Drainage Service Provider(if Public) <br /> Required to: Ponds <br /> Proposed El <br /> Existing❑ <br /> Private Storm <br /> Drainage ElOn-siteRetention Pond s ElNatural Drainage/No Chane Other El <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> E 4-s/ e T4 _ D"-S/-/ -- <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 /> O46 <br /> 1 1 Yes ElNo PO Yes ElNo N <br /> 19,- ar O a 301 0 - Z-0 Yes❑ No Yes ElNo <br /> Proposed 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 /> F:\DFvsvC\Plannin9 Application Forms\ Page 4 of 7 <br /> Lot Llne Aojuslment.00c.(Revis d 0511-09) <br />