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d APPLICATION - LOT LINE ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT., FILE NUMBER: PROPOSED PARCELS Existing Square Proposed Square Parcel Number Existingor Proposed Use or Parcel Foota a or Acrea a Footage or Acreage 1 Grazin 10.00 Acres 2 Grazin 225 Acres SITE IMPROVEMENTS AND SERVICES Water Annex Formation Distance to Public Public Water Required Water(Feet) Proposed ❑ Service Provider Existing ❑ Private Water ® Existing Well ElNew Well ® Well Replacement ❑ Sewage Disposal Annex Formation Distance to Public Public Sewage Disposal Service Provider Required Water(Feet) Proposed ❑ Existing ❑ On-Site Sewage Private Water ® Existing Septic System ❑ New Septic System ® Other Storm Drainage Public Storm Formation Terminal Drainage Detention-Retention Disposal Service Provider if Public Required To: Ponds Proposed ❑ Existing ❑ Private Storm On-site Retention Pond(s) ❑ Natural DrainagelNo Change ® Other Drainage❑ Electricity Tele hone Service Distance to Service Provider Service Service Provider Distance to Service -------------- - P.G.&E. Ad"acent SBC A acen School Service Fire Protection Service 4 Distance to Elem Distance to Fire Service Provider School Service Provider Station Lodi Unified School District 5 Miles Clements Rural 6 les Existin Roads RoadlStreet Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks Johnson Rd. 40' 24' ❑ Yes ® No ❑ Yes ® No ❑ Yes ❑ No ❑ Yes ❑ No Pro osed Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No F:IDEVSVC\Planning Application Formsli Page 4 of 7 Lot Line Adjustment.doc (Revised 6-04-04 a k Page 5 of 7 F tDEvsVC}Planning Application Formsl Lot Line Adiustmenl.doc.(Revised 6A-04)