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APPLICATION - LOT LINE ADJUSTMENT <br /> c' SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> '• FILE NUMBER- — __________ ____ <br /> �P <br /> IFp'R <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Ann tion Distance to Public <br /> Public Water Service Provider Re uired Water Feet <br /> Proposed❑ <br /> Existing❑ S.S.J.I.D. (Irrigation) <br /> Private\Nater X Existino Well X New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Re uired Sewer Facilitv <br /> Proposed ❑ <br /> Existin ❑ <br /> On-site Sewaa9e <br /> Dis osal Lxl Existing Septic System uZI 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 to: Ponds <br /> Existing ❑ <br /> Private Storm <br /> Draina e X On-site Retention Pond(s) Natural Drainage/No Change Q Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> PG&E On-Site AT&T I On-Site <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> E.U.S.D. -Dent Elementary 4.84 miles Escalon Fire Protection District 4.05 miles <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gufler Sidewalks <br /> Private Road- Haskell Lane 30' 14' *'- Yes❑ No Q Yes❑ No X <br /> Yes ❑ No❑ 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:IDEVSvc%Plannin9Application Formal Page 4 of 7 <br /> Lot Line Adjustmentdoc.(Revised 0511-09) <br />