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AQ�r� APPLICATION - LOT LINE ADJUSTMENT <br /> —A =x S/,N JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> f FILE NUMBER: <br /> •Q(,lFOR� <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existinq or Proposed Use of Parcel Footage or Acrea e Footage or Acreage <br /> 'C' '31 <br /> �_ � �� -7, 7 <br /> . l <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed ❑ <br /> Existin ❑ <br /> Private Water Existinq Well J New Well ❑ Welk Re lacement- <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service: Provider Required Sewer Facility <br /> Proposed ❑ <br /> Existin ❑ <br /> On-site Sewage <br /> Dis osai Existing Se tic S stE m New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Puklic) Annex-Formation Terminal Drainage Detention-Retenlion <br /> Proposed ❑ Required to: Ponds <br /> Existing ❑ <br /> Private Storm <br /> Draina e On-site Retention Pcnd s ❑ _ Natural Drainage,. Chane Other ❑ E <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider DistancWee <br /> School Service Fire Protection Service <br /> Distance to Elern <br /> Service Provider School Service Provider Distance <br /> 4. <br /> Ile- <br /> Existin Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes ❑ No❑ <br /> Yes ❑ No ❑ Yes ❑ No❑ <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No C l <br /> Yes❑ No❑ 1 Yes❑ No❑ <br /> F:IDEVSVC1PIanning Application Formsl Page 4 of 7 <br /> Lot Line Adjustment.doc.(Revised 05-11-09) <br />