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i <br /> ''' .APPLICATION LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> r <br /> ' FILE NUMBER: <br /> 4L4FORN <br /> PROP-08 D PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existin or Pro sed Use of Parcel Existing <br /> a or Acreage Footage or Acrea e <br /> r r es Grapes + <br /> Z ct I K vis 0- <br /> _T df :t <br /> SI"1 Jlr?IMPI20VEMENTS•AND SERVICE <br /> Water <br /> Annex-Formation Distance to Public <br /> I Public Water Service Provider Re uired Water Feet <br /> Proposed❑ <br /> Existing❑ <br /> f <br /> Private Water ExistiN Well ❑ New Weil Well Replacement ❑ <br /> [Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed❑ <br /> Existing❑ <br /> On-site SeWage <br /> Diseosa[LK Existing Se tic System ❑ New Septic SyRtem ❑ Other ❑ <br /> Stormii3rInage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ Required to: Ponds <br /> Existing❑ <br /> Private Stomy <br /> Ilraina a On-site Retention Ponds El Natural Drain elNo Chane Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to ervice <br /> School Service Flrie Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> t D � oar O V lwl h�— <h i <br /> - <br /> aadlStreet NameQQ R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> likw O V Q, C5 830 : t Yes❑ No Yes❑ No <br /> Yes❑ No❑ Yes❑ No❑ <br /> Pro ,:-:..d=Roiads <br /> Road/Street Name R.O.W.Width Pavement Width CurbIGutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No El— Yes No a-11 <br /> FADEvSvMPlanning Application Formsl Page 4 of 7 <br /> Lot Line Adjustment•dor..(Revised 05-11-09) <br />