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I �qury APPLICATION - LOT LINE ADJUSTMENT <br /> r. SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER; <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage <br /> I <br /> 55f acs <br /> rex AC-5 Z- 3 s <br /> arcs 3 - 5 ?:7 s 2, �s <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider <br /> Proposed F1Re uired Water Feet <br /> Existing ❑ <br /> Private Water Existing Well 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 System New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> f 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 /> Draina a 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 /> 40 44 Ll ca /.7t *I'(`s L•6 I't fry s int 3. � Olt"G1 S <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> 4b 25 Yes❑ No Yes❑ No <br /> Yes❑ No❑ Yes❑ No❑ <br /> Proposed Roads <br /> Road/Street Name R.O-W,Width Pavement Width Curb/Gutter Sidewalks <br /> QS ev a /rt Yes❑ Na❑ Yes❑ No❑ <br /> Yes❑ No ❑ Yes❑ No ❑ i <br /> I'MEVSVOPlanning Application Forms\ Page 4 of 7 <br /> Lot Line Adjustment.doc.(Revised 64-04) <br />