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t <br /> vl„ APPLICATION - LOT LINE ADJUSTMENT <br /> r` s\ SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> N� <br /> FILE NUMBER: <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage <br /> 1 Agriculture w/Farm Labor Mobile Home 29.02 Ac.Gross <br /> 2 Agriculture 23.65 Ac. <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® Existing Well ® New Well ❑ Well Re lacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facilit <br /> Proposed ❑ <br /> Existing ❑ <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 ❑ Re uired to: Ponds <br /> Existing ❑ <br /> Private Storm <br /> Drainage ® On-site Retention Ponds ❑ Natural Drainage/No Chane ® Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> PG&E Existing AT&T Existing <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> Ripon Unified 2.5 Miles Ripon 2.6 Miles <br /> Existing Roads <br /> Road/Street Name R.O.W. Wdth Pavement Width Curb/Gutter Sidewalks <br /> River Road 60' 26'(estimate) 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 /> N/A Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> FADEVSVC\Planning Application Forms\ Page 2 of 3 Job No 2011-148 LLA.doc <br /> Lot line Adjustment.cm.(Revised 6.4-04) <br />