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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use or Parcel Footage or Acreage Footage or Acreage <br /> 1 8.30 AC 5.10 AC <br /> 2 8.52 AC 11.72 AC <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Public Water Annex Formation Distance to Public <br /> Proposed❑ Service Provider Required Water(Feet) <br /> Existing❑ <br /> Private Water ❑ Existing Well ® New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex Formation Distance to Public <br /> Disposal Service Provider Required Water Feet <br /> Proposed ❑ <br /> Existing ❑ <br /> On-Site Sewage <br /> Private Water ❑ Existing Septic System ® New Septic System ® Other ❑ <br /> Storm Drainage. <br /> Public Storm Annex Formireation Terminal Drainage Detention-Retention <br /> Disposal Service Provider If Public Re ud To: Ponds <br /> Proposed ❑ <br /> Existing ❑ <br /> Private Storm <br /> Drainage❑ On-Site Retention Pond(s) ❑ Natural Drainage/No Change ❑ Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> P.G.&E. Ad acent SBC Adjacent <br /> School Service - Fire Protection Service <br /> Distance to Elem I Distance to Fire <br /> Service Provider School Service Provider I Station <br /> Lodi Unified School District 1 Mile Linden-Peters 5 Miles <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Jack Tone Road 80' 24' ❑ Yes ® No ❑ Yes ® No <br /> ❑ Yes ❑ No ❑ Yes ❑ No <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> N/A ❑ Yes ❑ No ❑ Yes ❑ No <br /> ❑ Yes ❑ No ❑ Yes ❑ No <br /> F:\DEVSVC\Planning Application Forms\) Page 4 of 7 <br /> Lot Line Adjustment.doc(Revised 6-04-04 <br />