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y <br /> APPLICATION - LOT LINE ADJUSTMEIV' <br /> �= y� SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> N; X <br /> FILE NUMBER: <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Pro osed Use of Parcel Footage or Acreacle Footage or Acreage <br /> P,4c c <br /> w <br /> r <br /> a <br /> SITE IMPROVEMENTS AND SERVICES v ' <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed❑ , <br /> Existing❑l I +�'. x�.,. ,. ''�.a ■° �- �.. ..�c' pd„W,i ° "• `; .,'` .s'.r,:r .r ., <br /> 'YR 8 *' c ^ <br /> Private Water ExistingWell ❑ New Well Well Rr; lacement r <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facili <br /> Proposed❑ <br /> Existing❑ <br /> On-site Sewage <br /> DisposalDisposalK Existing Septic System ❑ New Se tic S stem a 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❑ r, 'k <br /> Private Storm <br /> Drainage❑ f On-site Retention Ponds ❑ Natural Drainage/No Chane Other ❑ <br /> Electricity Telephone Service <br /> Distance to ,, <br /> Service Provider Service Service F;rovide'r`', `' Distance to Service <br /> School Service Fire 0rotection Service <br /> Distance to Elem <br /> Service ProviderSchool Service Provider mR t x - : Distance to Fire Station <br /> 02 <br /> Ladi L i lad wo acs- o <br /> Existin Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> -Yes❑ No,g Yes❑ No;K <br /> A <br /> Yes❑ No❑ Yes❑ No❑ <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> 410 Yes❑ No❑ Yes❑ No❑ <br /> Yes ❑ No❑ Yes❑ No❑ <br /> FADEVSWPlanning Application Forms% Page 4 of 7 <br /> Lot line Adjustment.doc.(Revised 05-11-08) <br />