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oPq� °� APPLICATION — LOT LINE ADJUSTMENT <br /> Q: j SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> �� - FILE NUMBER: <br /> C" <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage <br /> CX 'sr ,tu& S, 9 )-c 6 A-c <br /> Z 15' W& ' A-( / it c. <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Proposed❑ Re uired Water Feet <br /> Existin ❑ <br /> Private Water,- Existing Well New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> ffExisting <br /> blic Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Re uired Sewer Facili <br /> oposed❑ <br /> ❑ <br /> On-site Sews e <br /> Disposal 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 ❑ Required to: Ponds <br /> Existing❑ <br /> Private Storm <br /> Drainage On-site Retention Pond s ❑ Natural Drainage/No Chane Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> — 2N-5i jj?�. <br /> ' . / rt- <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> Ex at ng Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> M �- V_J_llE. F_oA- t Z 4--1 Yes❑ No[29- Yes❑ No® <br /> Yes❑ No❑ Yes❑ No❑ <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> A Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> FOEVSVC1Planning Application Foons\ Page 4 of 7 <br /> Lot Line AejustmentAm.(Revised 64-04) <br />