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oP4�t'� 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 Acrea e Footage or Acreage <br /> a,­v --)) 7Vz-JVbS'tn S�w6rl>G- �l�vt^Y 'Z S 6—b �►D <br /> �{ Zc�` RF a9r ►t t r J r t 4- Ja "-v <br /> ra <br /> 'FoltTI Wu u t1 k H f7T 4-L�3 <br /> Lbi 'L[A 2U`A9) <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider <br /> Proposed Required Water Feet <br /> �, T <br /> Existin ❑ C�t'�L� tllti_yJ �'�/�: v� ��Yl�l h1 cwE SE,� <br /> Private Water❑ Existing Well ❑ New Well n Well Replacement n <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed e �E 4 _ <br /> Existing[j ��i J Q�t tt�L 'SWK1-► l i JwJ <br /> i a Old .� <br /> On-site Sewage <br /> Disposal❑ Existing Septic System ❑ New Septic System n Other n <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ Required to: Ponds <br /> Existing❑ <br /> Private Storm <br /> Draina el. 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 /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> aA Yes ❑ No Yes ❑ No <br /> Yes ❑ No❑ Yes ❑ No El— <br /> Proposed <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width I Pavement Width Curb/Gutter Sidewalks <br /> Yes ❑ No❑ Yes❑ No❑ <br /> Yes ❑ No❑ Yes ❑ No❑ <br /> F:\DEVSVCWIanning Application Forms\ Page 4 of 7 <br /> Lot Line Adjustment doc.(Revised 6-303) <br />