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X-PLICATION - LOT LII-*E ADJUSTMENT <br /> a �t FUG <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> X <br /> 9<iF"'pi'�P <br /> FILE NUMBER: <br /> PROPOSED PARCELS <br /> Parcel Number Existing Square Proposed Square <br /> Existin or Pro sed Use of Parcel Foota a or Acrea a Foota a or Acreage <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Proposed ❑ Required Water Feet <br /> Existin ❑ /iw-1. <br /> Private Wate Existing Well New Well ❑ Weil Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage <br /> Annex-Formation Distance to Public <br /> Disposal Service Provider <br /> Proposed E] Re wired Sewer Facility <br /> Existin ❑ <br /> On-site Sewage <br /> rrjDis osalExisting Septic System 5CNew Septic S stem ❑ Other ❑ <br /> Storm Drainage <br /> f:Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed ❑ Required to: Ponds <br /> Existing❑ - <br /> Private Storm <br /> Drainage❑ Onsite Retention Ponds ❑ Natural Draina a/No Chane Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> Existin Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter - Sidewalks <br /> u' b Yes❑ NoN Yes❑ No M_ <br /> Yes❑ No❑ 'Yes❑' No❑ <br /> Pro osed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ I Yes❑ No❑ <br /> FA)EVSMPlanning Application Formsl Page 4 of 7 <br /> Lot Line Adjustment.doc.(Revised"-03) <br />