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4�1� APPLICATION - LOT LINE ADJUSTMENT .ti SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT e: < FILE NUMBER: PROPOSED PARCELS Existing Square Proposed Square Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage moo- 05 e-1 L 6?P-G- -Z3 7S-23 (- S o (-31+ 5-2,w 2— SITE SITE IMPROVEMENTS AND SERVICES Water Annex-Formation Distance to Public Public Water Service Provider Required Water Feet Proposed ❑ MH�9 Existin �C> Private Water❑ Existing Well ❑ New Well ❑ Well Replacement ❑ Sewage Disposal Public Sewage Annex-Formation Distance to Public Disposal Service Provider Required Sewer Facility Proposed❑ Existinq S2 N u On-site Sewage Dis osaI E] Existing Septic System ❑ New Septic System ❑ Other ❑ Storm Drainage Public Storm Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention Proposed❑ Required to: Ponds ?y M 0 O e�D GA%f Jt— Private Storm Draina e❑ On-site Retention Ponds ❑ Natural Draina e/No Chane ❑ Other ❑ Electricity Telephone Service Distance to Service Provider Service Service Provider Distance to Service l+�l �D PrT T School Service Fire Protection Service Distance to Elem Service Provider School Service Provider Distance to Fire Station t_. J. 5• G MI HG SQ .5 Ml Existing Roads Road/Street Name R.O.W.Width I Pavement Width Curb/Gutter Sidewalks �1t/Ei�1SlHI0 54t 36 t Yes No ❑ Yes No❑ �h— O� �j�. r Yes� No ❑ Yes No❑ n ��QvtS u�+^t b2 Gl O! K �i Proposed Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks Yes❑ No ❑ Yes❑ No❑ Yes❑ No ❑ Yes❑ No❑ F:MEVSVCT1ann1ngApp11ce bn Forms. Page 4 of 7 Lo'.Line A.djusnentdm.(Re\dsed 05-11-oe)