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APPLICATION - LOT LINE ADJUSTMENT <br /> - <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> �•fi �fi �„ �� fi � ��Flc7pp51:C1 pAFiGlw�� 9:Y42f fi",� �.��:����� � f, �fi �fi <br /> Parcel Number Existing or Proposed Use of Parcel Existing Proposed <br /> Square Footage Square Footage <br /> or Acreage or Acreage <br /> p c �c. <br /> C <br /> f # <br /> # srlav ► 'aN sricEs <br /> M.fi <br /> K. <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Existing❑ Required Water(Feet) <br /> Proposed❑ <br /> Privato Water Existing Well New Well O Well Replacement ❑ <br /> Sew, DEapnsal r <br /> Public Sewage Service Provider Annex-Formation DEstanoe to Publie <br /> Disposal Required Sewer Facility <br /> Existing❑ <br /> Proposed❑ <br /> On-site Sewage Existing Septic System New Septic System ❑ Other ❑ <br /> Disposal - <br /> e. :, ,f <br /> Grain <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 Ponds) a Natural Drainago/No Change,K mar ❑ <br /> Drainage <br /> � < f <br /> a £It clicfty s fi '> x o trraf tiLB <br /> Service Provider Distance to Service Service Provider Distance to <br /> Service <br /> f ON S�` 1 I aP4,4,!5 Dtil 5i- <br /> # <br /> T+~lephone'Serirke x ' CabieT.ekvisloR-SettAoe# <br /> 'Service Provider Distance to Service Service Provider Distance to <br /> Service <br /> Q t C7I1 <br /> z�i�:e r�.,fr��z� s ,�:.,�;t,�Ct10Cf$ErYfa�a�c r:R,9K3'�' h'" �*�r.t, a;=,.n��,�,klra Prolealfor►ter+rtcti��fr �*�� ',,r '?' <br /> Service Provider Distance to Elem Service Provider Distance to Fire <br /> School Station <br /> PG'N <anl c rr s <br /> r iFe-:5 x ',�xsS r+r ao ref rr- <br /> .:rr .'A`k ?,';;-'' <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yee O No 41, Yes❑ No R <br /> Yea❑ No❑ Yee❑ No a <br /> 2> x _�lkx { ab {rlppp Floada <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalk* <br /> fJ Yes❑ No O Yes❑ No❑ <br /> Yes Cl No a Yes❑ No a <br /> -3- <br />