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oA4 IK. APPLICATION - LOT LINE ADJUSTMENT Q' SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT N. < ••.c: P�• FILE NUMBER: A��FORN PROPOSED PARCELS Existing Square Proposed Square Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage 1 Agriculture w/Residence 5.00 Acres 2 Agriculture 5.00 Acres 3 Agriculture 5.00 Acres 4 Agriculture 23.23 Acres SITE IMPROVEMENTS AND SERVICES Water Annex-Formation Distance to Public Public Water Service Provider Required Water Feet Proposed❑ Existing❑ Private Water® Existing Well ® New Well ❑ Well Replacement ❑ Sewage Disposal Public Sewage Ann tion Distance to Public Disposal Service Provider Re uired Sewer Facility Proposed❑ Existing❑ On-site Sewage Disposal® Existing Septic System ® 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 Drainage® On-site Retention Ponds ❑ Natural Drainage/No Change ® Other ❑ Electricity Telephone Service Distance to Service Provider Service Service Provider Distance to Service PG&E Existing AT&T Existing School Service Fire Protection Service Distance to Elem Seryice Provider School Service Provider Distance to Fire Station Escalon Unified 1 Mile Escalon 4.5 Miles Existing Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter I Sidewalks State Highway Route No. 120 78.76' 50'(Estimate) Yes❑ No® I Yes❑ No Yes❑ No❑ I Yes ❑ No❑ Proposed Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks NIA Yes❑ No❑ Yes ❑ No❑ Yes ❑ No❑ Yes❑ No❑ F:\DEVSVC\Planning Application Fonns\ Page 2 of 3 Job No 2015-245 LLA Lot Line Adjustment.doc.(Revised 05-11-09)