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tRUIH. APPLICATION - LOT LINE ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT FILE NUMBER: da PROPOSED PARCELS Existing Square Proposed Square Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage 1 Residential and vineyard 4.5 6.6 2 Residential and vineyard 1 1.3 3 Residential and vineyard 4.5 1.6 SITE IMPROVEMENTS AND SERVICES Water Annex-Formation Distance to Public Public Water Service Provider Required Water Feet Proposed El Existing ❑ Private Water❑ New Well ❑ Well Re lacement ❑ Sewage Disposal Public Sewage Annex-Formation Distance to Public Disposal Service Provider Required Sewer Facility Proposed ❑ Existing ❑ On-site Sewage Disposal Existing Septic System ❑r New Septic System ❑ Other ❑ Storm Drainage Public Storm Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention Proposed ❑ Required to: Ponds Existing ❑ Private Storm Draina e ❑ On-site Retention Ponds ❑ Natural Draina e/No Chane El ❑ Electricity Telephone Service Distance to Service Provider Service Service Provider Distance to Service PG&E on-site S.B.C. on-site School Service Fire Protection Service Distance to Elem Service Provider School Service Provider Distance to Fire Station Lodi Unified School District 2 miles Mokelumne 2 miles Existing Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks Locust Tree Road 40 feet 22 feet Yes❑ No +❑ Yes❑ No El Yes❑ No❑ Yes ❑ No❑ Proposed Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks Yes❑ No❑ Yes❑ No❑ Yes❑ No❑ Yes ❑ No❑ F.IDEVSVC1Planning Application Forms) Page 4 of 7 Lot Line Ad)uetmentdoc.(Revised 6-4-04)