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op4'ty... APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTM•."4dT <br /> C i � <br /> FILE NUMBER: <br /> LIFORH4 <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Foota a or Acreage Footage or Acreage <br /> t u rv�r �c o <br /> /,/,/ 30,46 t/— <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed <br /> Existin ❑❑ <br /> Private Waterg Existing Well _ New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider L Required Sewer Facility <br /> Proposed ❑ N ^, �_ /✓/�. <br /> Existing ❑ <br /> On-site Sewage <br /> DNew Septic System ❑ Other ❑ <br /> is osal Existing � <br /> Septic System <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed ❑ Required to: 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 /> F 6:�- ew—Si rr 'T' G I >�N -• <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider= School Service Provider Distance to Fire Station <br /> Y 5 iw — U/Jy " f _ <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No fB Yes ❑ No IS[ <br /> Yes ❑ No❑ Yes❑ No❑ <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> /V /�/ Yes❑ No❑ Yes ❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> FADEVSVOPIanning Application Forms\ Page 4 of 7 <br /> Lot Line Adjustmenl.doc.(Revised 05-11-09) <br />