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L <br />' APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> l ' ej FILE NUMBER: <br /> PROPOSED PARCELS gS <br /> Existing Square Proposed Square <br /> Parcel Number Existingor Proposed Use of Parcel Footage orAcreage Footage or Acrea e <br /> 4 '601,2Cr S 260 � <br /> to atJJ e r <br /> i — <br /> I e <br /> c o - 4 �o vYle e Q ?'ass <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> PublifWatner Service Provider Required Water Feet <br /> PropExis <br /> a <br />! Private Water Existing Well New Well Wel!Replacement <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Re uired Sewer Facility <br /> Proposed❑ <br /> Existing. <br /> On-site Sewage <br /> Dis osal 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 /> ❑ Required to: Ponds <br /> Proposed <br /> Existing❑ <br /> Private Storm <br /> Drainage On-site Retention Ponds Natural Drainage./No Chane Other <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> G• s E on :51-t L7 -F Lk e_ <br /> School Service Fire Protection Service <br /> aY �e not Distance to Elem <br /> ervice Provider School Service Provider Distance to Fire Station <br /> CLC Ute: e b51 ;le CLC ce o� 3 , del 1 e <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> (X E DR ao -a Yes❑ No Q Yes❑ No Or <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❑ Yes❑ No❑ <br /> F:�DEVSVC�Pianning Application Forrrrsl Page 4 of 7 <br /> Lot Line Adjustment.doc.jRevised 6-4-04) <br />