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4 o�' urnr, c X i • Abri=o`Ra� APPLICATION - LOT LINE ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT FILE NUMBER: F OEVSMPlanning Application Forms\ Page 2 of 3 Job No 2011-167 Lot Line Adjustment.doc Lot Line Adjustment.doc. (Revised 05-11-09) PROPOSED PARCELS Parcel Number Existing or Proposed Use of Parcel Existing Square Footage or Acreage Proposed Square Footage or Acreage 1 Agriculture w/Residence 4.71 Acres 2 Agriculture 89.42 Acres SITE IMPROVEMENTS AND SERVICES Water Public Water Service Provider Annex -Formation Required Distance to Public Water (Feet) Proposed ❑ Existing ❑ Private Water ® Existing Well ® New Well ❑ Well Re lacement ❑ Sewage Disposal Public Sewage Disposal Service Provider Annex -Formation Required Distance to Public Sewer Facility Proposed ❑ Existing ❑ On-site Sewage Disposal ® Existing Septic System ® New Septic S stem ❑ Other ❑ Storm Drainage Public Storm Drainage Proposed ❑ Service Provider (if Public) Annex -Formation Required Terminal Drainage to: Detention -Retention Ponds Existing ❑ Private Storm Drainage ® On-site Retention Ponds ❑ Natural Drainaa/No Chane ® Other ❑ Electricity Telephone Service Service Provider Distance to Service Service Provider Distance to Service PG&E Existing AT&T Existing School Service Fire Protection Service Service Provider Distance to Elem School Service Provider Distance to Fire Station Tracy Unified 2 Miels Unprotected NIA Existing Roads Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks Howard Road 80' 28' (Estimate) Yes ❑ No ® Yes ❑ No Proposed Roads Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks N/A Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ F OEVSMPlanning Application Forms\ Page 2 of 3 Job No 2011-167 Lot Line Adjustment.doc Lot Line Adjustment.doc. (Revised 05-11-09)