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r <br /> APPLICATION ® LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> + -, FILE NUMBER: <br /> PROPOSED PARCELS <br /> Parcel Number Existing Square Proposed Square <br /> Existing or Proposed Use of Parcel Foota a or Acreage Foote a or Acrea e <br /> 0 , <br /> 46 Af 13 AL_ <br /> to t[4 p <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Proposed ❑ / Required Feet <br /> Existin j L.9 — [ <br /> Private Wate ExistingWell ❑ New Well ❑ Well Re lacement ❑ <br /> Sewage Disposal <br /> Public Sewage <br /> Disposal Annex-Formation Distance to Public <br /> Proposed ❑ s Service Provider Required Sewer Facility <br /> Existin ❑ <br /> On-site Sewage <br /> Dis osal ❑ Existin Se tic S stem ❑ New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed F1 <br /> Existing❑ Re uired to: Ponds <br /> r V� <br /> Private Storm <br /> Drainage ❑ On-site Retention Pond s E] Natural Draina a/No Chan e Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider <br /> ® L✓ Distance to Service <br /> School Service Fire Protection Service <br /> Service Provider Distance to Elem <br /> _ School Service Provider Distance to Fire Station <br /> a O <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> QL b Yes❑ NORYes❑ No <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❑ IYes❑ No❑ <br /> F:0EV8VQPlannin9 Application Foninsl Page 4 of 7 <br /> Lot Line Atlluelment.doc.(Revised 6-4-04) <br />