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APPLICATION - LOT LINE ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT W `4 FILE NUMBER: P AR C S .... . Existing Square Proposed Square Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage RESIDENTIAL & AGRICULTURAL I AC ;L 4.44 AC +- 2 AGRICULTURAL 8 AC + 4.65 AC + J. `SITE IMPROVEMENTS SERVICES Water t -W a.. ,.... Annex-Formation Distance to Public Public Water Service Provider Required Water(Feet) Proposed F1 F—PrIvate Water Existing Well New Well El Well Replacemen Public Sewage Annex-Formation Distance to Public Disposal Service Provider Required Sewer Facility Proposed R Existing Ej On-site Sewage Existing Septic System _tic Disposal New Sep Systern ❑ Other 0 % st6 4 Public Storm Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention Proposed FI Required to: Ponds Existing E] Private Storm Drainage 2j 1 On-site Retention Pond(s) ❑ Natural Drainage/No Change Other ❑ Te�16phone Sbi "911,ym �vIce 'Ell 6*11' --7 Distance to Service Provider Service Service Provider Distance to Service PG & E ION-SITE SBC OH-SIIE Protect)on-6,"', 6irvied' Distance to Elern Service Provider School Service Provider Distance to Fire Station LODI UNIFIED 5 MILES WOODBRIDGE FIRE DIST. 3 MILES q "T ..,Existing Roaft Road/Street Name R.O.W.Width I Pavement Width Curb1G,tter Sidewalks LUCAS ROAD 401. 201 Yes E] No Yes El Na Yes[:] NoEl Yes E] No❑ '7 "R IN , ropose Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks Yes E] No E] Yes D No ❑ Yes[:] No E] Yes E] No ❑ F:\DEVSVC\Plannlng Application Forrns\ Page 4 of 7 Lot Line Adjustment.doc.(Revised 6-4-04)