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APF �. ICATION -- LOT.,,.LINE A? ..r9 <br /> . � . _ DJUSTMENT. <br /> ' , ` ' -•'$ SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> i <br /> FILE NUMBER: <br /> NOm. <br /> l <br /> Exlsting5quarea :Proposejd Square <br /> Parcel tVurnber ExisGn or Pro` sed'Us' of Parcetel Foote e,or.Acrea e „ :Fooe or Acreage. r <br /> 0 A l Q <br /> ✓ Y-.- - �� NIS ': - <br /> r <br /> - <br />� <br /> Public Waterf ryAnnez=Formation -Distance to Public <br /> Service,Provider Re u[red Water Feet <br /> Proposed E. - . . .. . <br /> L Existin ❑ N Q� . <br /> Private Water Existinu Well New Well El Well Re lacement [] <br /> Publlc Sewage _ _ F <br /> Annex-Formation Distance to Public <br /> Disposal Service Provider <br /> 'Proposed Sewer Facility <br /> ❑ <br /> Existin [Q N <br /> On-site Sewage I <br /> Disposal❑ Existing Septic System New Septic S stem ❑ Other ❑ <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:Sen!lce. i <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> School Service Fire Protection Service <br /> —.-I.-Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> i <br /> i IM j <br /> - <br /> Existing Roads <br /> Road/Street Name R.Q.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No V Yes❑ No <br /> Yes❑ No❑ Yes❑ No ❑ <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement WidthCurb Gutter SidewaJD <br /> Yes© No❑ Yes 0 N <br /> Yes❑ No❑ Yes E3 No <br />)6SMPlanning Application Forms% Page 4 of 7 <br /> Uns Adlustment.doo.(ROVI"d i14_0) <br /> I <br />