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PLICATION;- LOT L IE ADJUSTMENT II, =s <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> ,a,�' <br /> PRoPbik PARIrEI.$ <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or AcFeage Footage or Acre e <br /> ,. .. StTEstllitPROYENICEN7"S ANp SERVICES.-`' . . . <br /> Walter <br /> Public Water Annex-Formation Distance to Public <br /> Service Provider R uired Water Feet <br /> Proposed❑ <br /> Existi ❑ <br /> Private Water Exis' Well New Well ❑ Well R lacement ❑ <br /> Sewage.Disposal <br /> Public Sewage Annex-Formation Distance-to Public <br /> Disposal Service Provider R uired <br /> Proposed Sewer Facili <br /> ❑ <br /> F..xisti ❑ <br /> On-site Sewage <br /> DispMl � Existi tic S m <br /> ❑ New Se tic S tem ❑ Other ❑ <br /> Storm[train <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 /> DrainNe On site Retention Ponds ❑ Natural,Drain e/No Chan e..ffl-_� Other .❑" <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> F—X i 6f(,Vvq Pxe.,fof ? Va.1./a 1we <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> Existing Roads <br /> Road/Street <br /> }}Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> G U 1,Y) /e 01 7 r oZ 6 Yes❑ NoX Yes❑ No <br /> Yes❑ No❑ Yes❑ No❑ <br /> _Prod Roads <br /> Road/Street Name R.Q.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ 'No❑ -Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> F WEVSVOPlanning Applicafwn Formsl Page 4 of 7 <br /> Lot line Adjustment.dor.(Revised 6-3-03) <br />