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y ot4'iy. APPLICATION - LOT LINE ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT w: < FILE NUMBER: �4(/FORN`P PROPOSED PARCELS Existing Square Proposed Square Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage 1 Agriculture w/Residence 10.00 Ac. Net 2 Agriculture w/Residence 54.36 Ac. Gross SITE IMPROVEMENTS AND SERVICES Water Ann tion Distance to Public Public Water Service Provider Re uired Water Feet Proposed ❑ Existing❑ Private Water® -Existing Well ® New Well ❑ Well Re lacement ❑ Sewage Disposal Public Sewage Annex-Formation Distance to Public Disposal Service Provider Required Sewer Facility Proposed ❑ Existing ❑ On-site Sewage Disposal® Existing Septic System ® New Septic System ❑ Other ❑ Storm Drainage Public Storm Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention Proposed ❑ Required to: Ponds Existing❑ Private Storm Drainage® On-site Retention Ponds ❑ Natural Drainage/No Chane ® Other ❑ Electricity Telephone Service Distance to Service Provider Service Service Provider Distance to Service PG&E Existing SBC Existing School Service Fire Protection Service Distance to Elem Service Provider School Service Provider Distance to Fire Station Tracy Unified 2 mi Tracy Rural 1 mi Existing Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks Larch Road 45' 22'(Estimate) Yes❑ No® Yes ❑ No Naglee Road 40' 22'(Estimate) Yes❑ No® Yes ❑ No Proposed Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks N/A Yes❑ No ❑ Yes ❑ No ❑ Yes❑ No ❑ Yes ❑ No ❑ FADEVSMPlanning Application Forms\ Page 2 of 3 Job No 2017-60 LLA Lot Line Adjustment.doc.(Revised 6-4-04)