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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 0 A- <br /> IN i'li. ...... <br /> 0, <br /> Parcel Number Existing or Proposed Use of Parcel Existing Proposed <br /> Square Footage Square Footage <br /> or Acreage or Acreage <br /> .......... <br /> �M <br /> MI: <br /> .......... . ....... <br /> ... ..... ...... <br /> ......... ....... <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Existing 0 Required Water (Feet) <br /> Proposed 0 <br /> Private Water)� Existing Well 0 New Well 0 Well Replacement 173 <br /> Public Sawage Service Provider Annex-Formation Distance to Public <br /> Disposal Required Sewer Facility <br /> Existing 0 <br /> Proposed 0 <br /> we Existing Septic System New Septic System 0 Other 0 <br /> Disposal <br /> ......... <br /> 7777 <br /> ... . ......... <br /> 2. XY­ <br /> 'R. <br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detention- <br /> Drainage Required to: Retention Ponds <br /> Existing 0 <br /> Proposed 0 <br /> Private Storm Onsite Retention Pond(s) 0 Natural Drainage/No Change Other C3 <br /> Drainage 0 <br /> Service Provider Distance to Service Service Provider Distance to <br /> Service <br /> z� <br /> X <br /> 01 <br /> Service Provider Distance to Service Service Provider Distance to <br /> Service <br /> Service Provider Distance to Elem Service Provider Distance to Fire <br /> School Station <br /> Ze7ll' <br /> ...... ................. <br /> ... ......... ....... . ........... ... ..... ... <br /> 0.4....... <br /> Road/Street Name P.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> No X Yea 13 No <br /> Yeso <br /> Yea 0 No E3 Yes o No ii <br /> Road/Street Name R.O.W.Wldth Pavement Width Curb/Gutter Sidewalks <br /> Yea O NoO Yes 0 No C1 <br /> Yea O NoO L Yes 0 No 0 <br /> -3- <br />