Laserfiche WebLink
>°- a ?—?PLICATION -- LOT L�74E�r � - S � � ADJUSTMENT <br /> l,n: ! . ,A AN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> . {IF- FILE NUMBER: <br /> PROPOSED PARCELS <br /> Parcel Number EXistinn or Pmosed Use of ParcelExisting Square Proposed Square <br /> Foota e or Acrea a Foota a or Acrea e <br /> X15 ;7, 3.4� <br /> X .mac <br /> 6,4L <br /> G AL'f At� r/ <br /> SITE IMPROV MENTS AND SERVICES <br /> Water <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Proposed ❑ Required Water <br /> Existin (Feet <br /> Private Waterer <br /> Existinin Well <br /> New Well Well Replacement ❑ <br /> Public Sewage Sewage Disposal <br /> Disposal Service Provider Annex-Formation Distance to Public <br /> Proposed❑ Re aired Sewer Faci6t <br /> Existin <br /> On-site Sewa e <br /> bis osal Existing Septic System ❑ <br /> .New Se tic System EL Other ❑ , <br /> PuStorm Drainage <br /> blic Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ Required to: <br /> Existing❑ Ponds <br /> Private Storm <br /> Draina ej On-site Retention Ponds <br /> Electricity ElNatural Drainage/No.Chane Other El <br /> Distance to Telephone Service <br /> Service Provider Service <br /> Service Provider Distance to Service <br /> School Service �� l <br /> Fire Protection Service <br /> Service Provider Distance to Elem <br /> School Service Provider Distance to Fire Station <br /> I <br /> Existin Roads <br /> Road/Street Name R.O,W-Width Pavement Width Curb/Gutter Sidewalks <br /> r � { 00 ! d 'l. — Yes[I Nom Yes El No E?, <br /> v/- <br /> Yes❑ No Yes❑ No <br /> Pro osed Roads <br /> Road/Street Name R-O.W.Width Pavement Width <br /> Curb/Gutter Sidewalks <br /> Yes ❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> F:IDEVSVcTlanning Application Forms\ <br /> Lot Line Adjustment.doc-(Revised 6-4-04) Page 4 of 7 <br />