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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage <br /> /73 -2 0-! - e&',-d ` 0 22 <br /> e 1-T • 3 4, !• 3 14 , <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed ❑ <br /> Existing❑ <br /> Private Water Existing Well 04 New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facilitv <br /> Proposed ❑ <br /> Existin ❑ <br /> On-site Sew <br /> Dis osal age Existing Septic System 54 New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed ❑ Required t0: Ponds <br /> Existing❑ <br /> Private Storm <br /> Draina e❑ On-site Retention Ponds ❑ Natural Drainage/No Chane Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> (> o ti OriO <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> V ,Ze e y <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No® Yes ❑ No <br /> Yes❑ No 5? Yes ❑ No Sa <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:TEVSVMPlanning Application Fonnsl Page 4 of 7 <br /> Lot Line Adjustment.doc.(Revised 05-11-09) <br />