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0�,441N. APPLICATION - LOT LINE ADJUSTMENT <br /> y� SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <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 /> / ENGE 50 A-c <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required <br /> Proposed Water Feet <br /> 171 <br /> Existing❑ <br /> Private Water Existing Well New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed ❑ <br /> Existing❑ <br /> On-site Sewage <br /> Dis osal �}— ing 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❑ Rpmuired to: Ponds <br /> Existing❑ <br /> Private Storm <br /> Draina e47- On-site Retention Pond s ❑ Natural Draina a/No Chance Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> zv.1/ alr 2 i1A f/_ /IAo�Gre Gr t -L nth t <br /> Ex sting Roads <br /> Road/Street Name 1 R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No 9- Yes❑ No 59 <br /> Yes❑ No❑ Yes❑ No❑ <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> N Yes ❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes ❑ No❑ <br /> F:\DEVSVC\Planning Application Fonns\ Page 4 of 7 <br /> Lot Line Adjustment.doc.(Revised 64-04) <br />