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op4�t'N` APPLICATION — LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> m: < <br /> FILE NUMBER: _. <br /> �4CiFoaW�p <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage <br /> 1 Rural residential/poultry farm 40 ac 10 ac <br /> 2 Vineyard/agricultural land 50 ac 80 ac <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Re uired Water Feet <br /> Proposed ❑ <br /> Existin ❑ <br /> Private Water® Existing Well ® New Well ❑ Well Re lacement ❑ <br /> Sewage Disposal <br /> tExist <br /> f <br /> e Annex-Formation Distance to Public <br /> Service Provider Re uired Sewer Facilit <br /> On-site Sewage <br /> Disposal ® Existing Septic System ® New Septic S stem ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm Detention-Retention <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage <br /> Proposed ❑ Re uired [o: Ponds <br /> Existing ❑ <br /> Private Storm <br /> Drainage ❑ On-site Retention Ponds ❑ Natural Drainage/No Chane ® Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> P.G&E. Adjacent AT&T Adjacent <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> Lodi Unified School District 5 Miles Clements 5 Miles <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Jack Tone Road 60' 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 /> F1DEVSMPlanning Application Fonns\ Page 4 of 7 <br /> Lot Line Adjustment.doc.(Revised 05-11-09) <br />