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I I� APPLICATION - LOT LINE ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT i MK ifl FILE NUMBER: PROPOSED PARCELS Parcel Number Existing or Proposed Ilse of Parcel Existing Square Proposed Square Foota a or Acreage Footage or Acreage ' 'I I RESIDENTIAL .44 acres 2 RESIDENTIAL nacres a.4a SITE IMPROVEMENTS AND SERVICES Water Public WaterAnnex-Formation Distance to Public Proposed ❑ Service Provider Required Water Feet —Existing SAN JOAQUIN COUNTY I Private Wafer r ❑ Existing Well ❑ New Well ❑ Well Re iaceme=E] I I Sewage Disposal Publfc Sewage 'j Dis osal Annex-Formation Distance to Public i P Service Provider Required Sewer Facility Proposed [I L Existin ❑ On-site Sewage Disposal Existing Septic System New Septic System ❑ Other ❑ Storm Drainage f Public Storm Drainage Service Provider(if Pubic) Annex-Formation Terminal Drainage Detention-Retention r Proposed ❑ Re aired to: Ponds i Existing' SAN JOAQUIN COUNTY Private Storm Drainage❑ On-site Retention Pond s ❑ Natural Draina e1No Chane ❑ Other ❑ Electricity Telephone Service Distance to k I Service Provider Service PG&E ori-site SBC Service Provider Distance to Service on-site School Service Fire Protection Service ' Service Provider Distance to Elem School Service Provider Distance to Fire Station } ' GALT SCHOOL DISTRICT 2 miles THORNTON 2 miles j Existing Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks PINE STREET so, Yes❑ No Yes❑ No :l Yes❑ No❑ Yes❑ No❑ { Proposed Roads Road/Street Name R.O.W.Width Pavement Width Curb[Gutter Sidewalks 1, Yes❑ No❑ Yes ❑ No❑ I Yes❑ No❑ Yes ❑ No❑ FADEVSVC)Plannincg Application Formsl Page 4 of 7 Lot Line Adjustmeni.doc.(Revised 13-4-04) I i