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APPLICATION - LOT LINE ADJUSTMENT - <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> w <br /> Parcel Number Existing or Proposed Use ot Pwoel Existing Proposed <br /> Square Footage Square Footage <br /> or Acreage or Acreage <br /> 14 <br /> s� x <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Existing❑ Required Water(Feet) <br /> Proposed❑ <br /> Private Water3 Existing Well New Well ❑ Well Replacement ❑ <br /> a' <br /> Public Sewage Service Provider Annex-Formation Distance to Public <br /> Disposal Required Sower Facility <br /> Existing 0 <br /> Proposed❑ <br /> On-site Sewage Existing Septic System Now Septic System ❑ Other ❑ <br /> Disposal�! <br /> 3tatM snag a ?< . ' <br /> Public Storm Service Provider Annex-Formation Terminal Drainage Dateon- <br /> Drainage Required to: Retentiontin Ponds <br /> Existing❑ <br /> Proposed❑ <br /> Private Storm Onsite Retention Pond(s) O Natural Drainage/No Change Other ❑ <br /> Dramsge . <br /> M . 'b. `�#, ` a qt, ccJ ';# eftnt• ` .:� <br /> :� <br /> Distance to Service Service Provider Distance to <br /> Service Provider Service <br /> J lc� <br /> h n Se a i 2 > ab[e eievlaloti",. 1 a , <br /> .., P 4.:. ,,:, <br /> Service Provider Distance to Service Service Provider Distance to <br /> ,t Service <br /> ( t rJ <br /> Service Provider Distance to Bern Service Provider Distance to Fire <br /> School Station <br /> `TJX ^s• sx i-- „� qy, � 'C�. � - xf x ���,;'y4c �< 4�,y, � �5. : <br /> RaadlStreet Name R.O.W.Width Pavement Width CurWtiuttor Sidewalks <br /> - Yes❑ NoYes❑ Nom <br /> Yea❑ No❑ Yes❑ No❑ <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No O <br /> Yea p No❑ <br /> Yea❑ No Li <br /> -3- <br /> r' <br />