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oPq�1�. Al. PLICATION — LOT LI6 _c ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT a .y FILE NUMBER: <<F ORN PROPOSED PARCELS Existing Square Proposed Square Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage 1 Residence/Grazing Land N/A 16.9 AC 2 Residence/Grazing Land 56.9 AC 40 AC 3 Grazing Land 12.5 AC 14.8 AC 4 Grazing Land 104.5 AC 103.5 AC SITE IMPROVEMENTS AND SERVICES Water Annex-Formation Distance to Public Public Water Service Provider Re wired I Water Feet Proposed ❑ Existin Private Water❑ Existin Well ® New Well ❑ Well Re lacement ❑ Sewage Disposal Annex-Formation Distance to Public Public Sewage Required Sewer Facility Disposal Service Provider Proposed ❑ Existin On-site Sewage New Se tic S stem ❑ Other ❑ Disposal El Existin Se tic S stem 171 Storm Drainage Public StormAnnex-Formation Terminal Drainage Detention-Retention Drainage Service Provider(if Public) Proposed ❑ I Required to: Ponds Existing ❑ Private Storm Draina e❑ On-site Retention Ponds ❑ Natural Drainage/No Chane ® Other ❑ Electricity Telephone Service Distance to Service Provider Service Service Provider Distance to Service P.G.&E. Adjacent Verizon Adjacent School Service Fire Protection Service Service Provider School Distance to Elem Service Provider Distance to Fire Station Lodi Unified 0.9 Miles Clements 1 Mile Existin Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks East State Route 12 100' 40' Yes❑ No® Yes❑ No Yes❑ No❑ Yes❑ No❑ Pro osed Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks N/A Yes E] No ElYes E] No El Yes❑ No❑ Yes❑ No❑ F:\DEVSVC\Planning Application Forms\ Page 4 of 7 Lot Line Adjustment.doc.(Revised 05-11-09)