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oPg�IN APPLICATION - LOT LINE AMUSTMENT r. y SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT •' FILE NUMBER: ,CjFORN PROPOSED PARCELS xisting S quare Proposed Square Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage Homesite .5+/-acres 2 Homesite .5 +/ acres 3 Agriculture 69+/-acres SITE IMPROVEMENTS AND SERVICES Water nnex ormationistance to Public Public Water Service Provider Required j Water(Feet) Proposed ❑ Existing ❑ Private Water 0 Existing Well 0 New Well Well Replacement Sewage Disposal Public Sewage Annex-Formation Uistance to Public Disposal Service Provider Required Sewer Facility Proposed F-] Existing E] On-site Sewage Disposal Existing Septic System ❑a New Septic System ❑ Other ❑ Storm Drainage Public Storm Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention Proposed F� Required to: Ponds Existing Private Storm Drainage On-site Retention Pond(s) Natural Drainage/No Change Other Electricity Telephone Service Distance to Service Provider Service Service Provider Distance to Service PG&E on-site AT&T on-site School Service Fire Protection Service (stance to Elern Service Provider School Service Provider Distance to Fire Station Lodi Unified School District 5 miles Mokelumne 5 miles Existing Roads Road/Street Name R.. W.Width Pavement Width Curb/Gutter Sidewalks Tretheway Road 60 feet 20 feet Yes ❑ No 0 Yes ❑ No 0 Kettleman Lane 50 feet 20 feet Yes ❑ No 0 Yes ❑ No 0 Proposed Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks Yes E] No E-] Yes E] No ❑ Yes E No Yes [:] No FA\DEVSVC\\Planning Application Forms\\ Page 4 of 7 Lot Line Adjustment.doc.(Revised 6-4-04)