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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT y <br /> tri <br /> Parcel Number Existing or Proposed use of Parcel <br /> Existing Proposed <br /> Square Footage Square Footage <br /> or Acreage or Acreage <br /> C1-t�\fel.! Gk,:o 5TAllcC j �.� ACDIs 5.1 ACAS <br /> ?' BUD r-. Bt12 HQt,I SHOP-t. <br /> - PFJ <br /> SITE;IMPR4VS AND riiYlC� $ " y: <br /> r-/ <br /> ^. xt ,c Waley Service Provider <br /> Fx'sting Annex Formation Distance to Public <br /> I� � <br /> I, <br /> Proposed Required Water (Feet) <br /> ^Private Water Existing Well I& New Well C7 Well Replacement ❑ <br /> 5t►1rw�gs)!1lappsaE .. /�/��,'�� ,/ �ail/ / /� <br /> f <br /> Ois <br /> Sewage Service Provider Annex-Formation Distance to Public <br /> Uisposai <br /> [ixlsting Ql Required Sewer Facility <br /> Proposed ❑ <br /> NO <br /> On-site Sewage Existing Septic System New Se <br /> DIsposal HOUoEc� Otic System ❑ Other D <br /> ti=`�l�a`f ttiJC�� <br /> StorrA E3rainage % r//moi%rri/ <br /> ?ublic Storm Service Provider Annex-Formation Terminal Drainage Detention- <br /> Required <br /> etention <br /> L`rninAge Re uired <br /> [=xisting � q to: Retention Ponds <br /> 1 roposed ❑ CoUF. N SERV ICS A&EA,i 5']11JC� <br /> No. I5 Sao C,S. h . 45 <br /> r iivnte Storm On-site Retention Pond(s) ❑ Natural Drainage/No Change ❑ Other ❑ <br /> Lrainnga �7 <br /> electricity..: „i/fir/11tt3iF.Gas i <br /> SorJico Provider Distance to Service Service Provider Distance toJ <br /> �. <br /> Service <br /> Talsphana Service N bldV[>ilo �.` �y <br /> Service provider Distance to Service Service Provider Distance to <br /> Service <br /> li Service Provider Distance to Elem Service Provider <br /> Distance to Fire <br /> School <br /> ---- --- Station <br /> ' . L-I►1 C7E�1 U KI I FIE ID i.3 till s WATERL�p MDQArL�c 3 M i <br /> Exirtlr} Ff fJJ/l f // / f <br /> J///, <br /> Road Streot Name R.Q.W. Width <br /> favemoat Width Curb/Dotter Sidewalks <br /> Yes❑ No t% Yea❑ No <br /> --14-r W/�/z- SECTIbf.i <br /> - g.r, 104i Yea CK No❑ Yes lq No ❑ <br /> .:- --: Pro <br /> -- RoadlStreei Name <br /> R.O.W. Width Pevemerd Width Curb/Gutter Sidewalks <br /> — D,� PROPCC'ED Yes❑ No ❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes D No ❑ <br /> -3- <br />