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o0.4�IN. APPLICATION — LOT LINE ADJUSTMENT <br /> r` '�' 'i SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> N. < <br /> FILE NUMBER: <br /> gGIFO�N <br /> PROPOSED PARCELS <br /> Exis I g quare Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Foots a or Acreage Footage or Acreage <br /> Q 22 A9:Z2 'LZ Ar, <br /> A _ :, I ode l 8 <br /> l SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feel <br /> Proposed <br /> Existin .- <br /> [ Private Water❑ Existing We115 New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed❑ <br /> Existing❑ <br /> On-site Sewage <br /> Disposal❑ Existing Septic S stermg New Septic System ❑ 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 /> f Private Storm <br /> l Drains e❑ On-site Retention Pond s ❑ 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 /> LIAj0&k! 0A F1E CA5( SiDi� sre_V_ , i <br /> Existing Roads <br /> Road/Street Name R.O.W.Width I Pavement Width Curb/Gutter Sidewalks <br /> EA- <br /> (ZLC. 2a Yes El No <br /> Yes❑ No <br /> Yes❑ No❑ Yes❑ No❑ <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> I F:\DEVSVCTianning Application Forms\ Page 4 of 7 <br /> 1 Lot Line Adjustmentdoc.(Revised OS-11-0g) <br />