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APPLICATION - LOT LINE ADJUSTMENT <br /> y: r .. SAN JOAClUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> _..;z <br /> '¢" FILE NUMBER: <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existingor Proposed Use of Parcel Footage or Acreage— Foota or Acrea e <br /> 3- 1 . Z , 8 t <br /> z y .3t , 3 -F <br /> 3 �. ; S .t 3, 7 <br /> SITE IMPROVEMENTS AND SERVIrAnnex#-Foormaitlon <br /> Water <br /> Distance to Public <br /> Public Water _ Service Provider equired Water Feet <br /> Proposed ❑ <br /> Existin <br /> Private Water Exist) Well New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal <br /> Service Provider Required Sewer Facili <br /> Proposed ❑ <br /> Existin <br /> On-site Sews e <br /> Uis oral <br /> Existing Septic System $) New Se tic S tem ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm Annex-Formation Terminal Drainage Detention-Retention <br /> Drainage Service Provider(if Public) Required to Ponds <br /> Proposed ❑ <br /> Existing ❑ <br /> Private Storm <br /> Drains On-site Retention Ponds El Natural Drainage/No Chane Other El <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> s,A& <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider school Service Provider Distance to Fire Station <br /> 0 <br /> / / h�i rr`cf hi <br /> d r V// � <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Q C� O!7 e / � v Q // r Z / Yes[I No Q� Yes ❑ No <br /> C <br /> R 4 P d ' Yes E] No Yes❑ No <br /> Pro sed 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:IDEVSVC\Planning Application Forms\ <br /> Page 4 of 7 <br /> Lot Line Adjuslment.doc.(Revised 05-11-M <br />