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APPLICATION LOT L1 ADJUSTMENT <br /> �o t o0 <br /> SAN JOAQUIN COUNTY COMMUNIT r'DEVELOPMENT DEPART <br /> MENT <br /> N: :< <br /> FILE NUMBER: <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existingor Pro sed Use of Parcel Footage or Acreage Footage or Acreage <br /> ails <br /> 2.. e-csc sorbrna �,� p RS Ac, 110.-7-7 <br /> f� <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 Water Existing Well New Well ❑ Weil Re lacement ❑ <br /> Sewage Disposal ,s <br /> Public Sewage Annex-Formation . Distance to Public <br /> Disposal Service Provider Required Sewer Facilit <br /> Proposed ❑ <br /> Existing❑ <br /> On-site Sewa e <br /> Disposal Existing Septic System New Septic System ❑ Other El <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 ❑ r <br /> Private St r <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 /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> .VN t J=t ' LOATML0 0 Hb( -O 1'-7- F-Le tre i <br /> Existing Roads <br /> Road/Street Na R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> ( O q0J 0' Yes[INo Yes❑ No Jq <br /> 14 <br /> 12 Yes❑ No Yes ❑ 'No K <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> WA Yes❑ No❑ Yes ❑' No❑ <br /> Yes❑ No❑ Yes ❑a. No ❑ k <br /> I <br /> FADEVSVCTianning Application Forms\ Page 4 of 7 <br /> Lot Line Adjustment.doc.(Revised 05-11-09) <br /> Y- ` <br />