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APPLICATION - LOT LINE ADJUSTMENT
<br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
<br /> T
<br /> Parcel Number Existing or Proposed Use of Parcel Existing Proposed
<br /> Square Footage Square Footag©
<br /> or Acreage or Acreage
<br /> 4- 5Z+ Z , oU G
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<br /> Public Water Service Provider Annex-Formation Distance to Public,
<br /> Existing Q Required Water (Feet)
<br /> Proposed ❑
<br /> Private Water Existing WellIx New Well Q Well Replacement ❑
<br /> Xl
<br /> a$i?b<isi#C%#52':t:a:::h:: :y-}:.k:.t...:.p•::C4::�:::::..{,...:++:d:
<br /> X.
<br /> Public Sewage Service Provider Annex-Formation Distance io Public
<br /> Dispose! Required Sewer Facility
<br /> Existing ❑
<br /> Proposed Q
<br /> On-site Sewage Existing Septic System New Septic System ❑ Other ❑
<br /> Disposal El
<br /> 5ttutb:01*1
<br /> 11rfg9.:' ;
<br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detention-
<br /> Drainage Required to: Retention Ponds
<br /> Existing ❑
<br /> Proposed❑
<br /> Private Storm On site Retention Pond(s) ❑ Natural Drainage/No Change Other ❑
<br /> Drainage❑
<br /> .0 Y
<br /> - '. Y:�::�:.y..... �$i ...:.,:r...t,.:h:v;.Cv::.;:.:h;r...}40:^-• �.; rvt4{ y
<br /> Service Provider Distance to Service Service Provider Distance to
<br /> i
<br /> Service
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<br /> Service Provider Distance to Service Service Provider Distance to
<br /> Service i
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<br /> : Y
<br /> .......+.v...,......v...................�.
<br /> Service.Provider Distance to Elem Service Provider Distance to Fire
<br /> School Station
<br /> D 1;T 1M 1 , D 04, 2 :
<br /> -------------
<br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks
<br /> Yes Q Na er— Yes❑ 1+kLB�
<br /> Yea ❑ No.2r' Yes❑ No
<br /> ,. i
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<br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks
<br /> Yes Q No Q Yes ❑ No O
<br /> Yes❑ No❑ Yes❑ No❑
<br /> -3-
<br /> i
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