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APPLICATION - LOT LINE ADJUSTMENT <br /> er SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> e: < <br /> FILE NUMBER: <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Foota a or Acrea e <br /> 067ttz41 5106PEZ PPRGEL D o33 suH t•Y7 Al S 7 aFr 1. S <br /> 097062y2 XesloErdLE PAW-Gt_ (ij X13 slso Fr ( M. Belo 1,12. AC <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Ann tion Distance to Public <br /> ffEstisn <br /> Service Provider Re uired Water Feet <br /> 146 K6 <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 Facili <br /> Proposed ❑ <br /> Existin ❑ NONt <br /> On-site Sewage <br /> Disposal❑ Existing Septic System New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> ffEn <br /> Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Re uired to: Ponds <br /> NoNr; <br /> Private Storm <br /> Drainage❑ On-site Retention Ponds ❑ Natural Drainage/No Change Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> Pate — AT- tT <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> LIN06N U K fIE Z M1LE3 WA Mo%ADP. 'IR6 r4lL6 <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> SDS-ARl AµLH SO' ZS' Yes❑ No® Yes ❑ No K <br /> Yes❑ No❑ Yes ❑ No❑ <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Not46 Yes❑ No❑ Yes ❑ No❑ <br /> Yes❑ No❑ Yes ❑ No ❑ <br /> F:IDEVSVQPIanning Appiica0on Forms\ Page 4 of 7 <br /> Lot Line Adjustment.dw.(Revised 6-404) <br />