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at nth- APPLICATION — LOT LINE ADJUSTMENT <br /> z' °t SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> w � < <br /> FILE NUMBER: <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage orAcreage Footage orAcreage <br /> 1 Ex St F'cS �.�u�c—`c' e-ti 5 7, tf-o2, <br /> Eki5-Felalc� �. 6 Z- A, <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 Wa[er EE�- Existing Well New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Ann tion Distance to Public <br /> Disposal Service Provider Re wired Sewer Facility <br /> Proposed❑ <br /> Existing❑ <br /> On-site Sewage <br /> Dis osalfg'- Existing Septic System New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed ❑ <br /> Required to: Ponds <br /> Existing❑ <br /> Private Stt�mt <br /> Drains a On-site Retention Ponds ❑ Natural Drainage/No Change Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> � t✓ ' � orv:-- S i Tc /� rt -`- T or.� - S r Tc <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> �--t p eL, S c•i 2-4 Yes❑ No 0' Yes❑ No❑: <br /> Yes❑ No❑ Yes❑ No❑ <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> N A� Yes❑ No❑ Yes❑ No❑ <br /> Yes ❑ No❑ Yes❑ No❑ <br /> F:IDEVSVc\Planning Application Fotms\ Page 4 of 7 <br /> Lot Line Adjustmentdw.(Revised 0611-09) <br />