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rPPLICATION — LOT L SE ADJUSTMENT <br /> .o <br /> 2` 'Z SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> PROS SIrDi PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage <br /> err/ e- - 61 <br /> An- <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed ❑ <br /> Existin ❑ <br /> Private Water Existing Well New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed ❑ <br /> Existin ❑ <br /> On-site Sewage <br /> DisposalDisposalx Existing Septic System New Septic 5 stem ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed ❑ Required to: Ponds <br /> Existing ❑ <br /> Private 5t rm <br /> Drainage 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 /> 147- a&- <br /> School Service Fire Protection Service <br /> Distance to Eiem <br /> Service Provider School Service Provider Distance to Fire Station <br /> r <br /> Existing Roads <br /> Road/Street Name R.O.W,Width Pavement Width Curb/Gutter Sidewalks <br /> J`I e. ©GI d 04C Yes ❑ Nor Yes ❑ No/74� <br /> Yes ❑ No,9 Yes ❑ No <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:SDEVSVCSPIan6ng Application Formsl Page 4 of 7 <br /> Lot Line Adjustment-doc.(Revised 6-3-03) <br />