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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> Q. l <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 /> 6 f 6a E 14:5.4( F <br /> —23 vv � 82. t• <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water(Feet) <br /> Proposec' <br /> Existing i t V <br /> Private Water ❑ Existing Well ❑ New Well ❑ Well Re lacement Lj <br /> Sewage Disposal <br /> Public Sewage Annex-Formafion Distance to Public <br /> Dis sal Service Provider Re uired Sewer Facilit <br /> Proposed ❑ <br /> Existin C :14Ze <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❑ I Required to: Ponds <br /> Existing oz <br /> Private Storm <br /> Drainage ❑ On-site Retention Pand(s) ❑ Natural Draina e/No Chane ❑ Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> GE o -S <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service ProviderSchool Service Provider Distance to Fire Station <br /> ° yM.I ,NLOL � .IiG <br /> ExistingRoads <br /> Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks <br /> ,5w,Fj2La,jjX 14 2y Yes[2 No❑ Yes[R No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> Proposed Roads <br /> r Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> 'J Yes ❑ No❑ Yes❑ No❑ <br /> FADEVSVOPlanning Application Forms\ Page 4 of 7 <br /> Lot Line Adjmtmwt.dm.(Revised 6-4-04) <br />