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<br /> APPLICATION - LOT LINE ADJUSTMENT
<br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
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<br /> Square Footage Square Footage
<br /> or Acreage or Acreage
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<br /> Public
<br /> Public Water Service Provider Annex-Formation Distance to Public
<br /> Existing❑ Required Water(Feet)
<br /> Proposed O
<br /> Private Water Existing Well X New Well Well Replacement ❑
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<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 ❑
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<br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detention-
<br /> Drainage Required to: Retention Ponds '
<br /> Existing ❑
<br /> Proposed❑
<br /> Private St On-site Retention Pond(s) 13 Natural Drainage/No Change Other ❑
<br /> Drainage
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<br /> Service
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<br /> Service
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<br /> Service Provider Distance to Elem Service Provider Distance to Fire
<br /> School Station
<br /> MA
<br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks
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<br /> Yes❑ No❑ Yes❑ No❑
<br /> -3-
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