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oP4..i.. APPLICATION — LOT LINE ADJUSTMENT <br /> >. o <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> ���rFOft�`P <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage <br /> Z Stfn �I 7rL✓cK- `ff)-/LP S/ A-� A- �- <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Ann tion Distance to Public <br /> Public Water Service Provider Re uired Water Feet <br /> Proposed❑ <br /> Existing g <br /> Private Water k Existing Well New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distanceto Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed❑ <br /> Existing Q <br /> On-site Sewage <br /> Disposal Existing Septic System 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 /> Private Storm <br /> Draina e,RL F On-site Retention Pond(s) Ag– Natural Drainage/No Chan a Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> 6 4 E oN-S rTE A-7- ,' ON—SITE <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> rSe'rmvice Provider School Service Provider Distance to Fire Station <br /> fit/f77EIZLs>a – /hatA,>� 2Existin RoaRoad/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑J.ArTc Yes❑ No Yes❑ No Q <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> *JYes ElNo ElYes[INo El <br /> Yes❑ No❑ Yes❑ No❑ <br /> F:\DEVSMPlanning Application Fonns\ Page 4 of 7 <br /> Lot Line AdjustmenUm.(Revised 6.4-04) <br />