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LOT LINE ADJUSTMENT <br /> CAM JpI�QUINCpUNTYCOMMUNITYDEV <br /> ELOPMENTDEPARTMF-IVT <br /> Parcel Number Existing or Proposed Use of Parte! <br /> Existing Proposed <br /> Square Footage square Footage <br /> or Acreage or Acreage <br /> 9gt91. t <br /> c Dyleti � alv �� /,fid .4 <br /> ill <br /> , , Ir <br /> t41. .. <br /> Public Water Service Provider Annex-Formation Distance to Public <br /> Existing 13 <br /> Proposed❑ Required Water(Feet) <br /> Private Water Existing We11 New Wel! 0 i-Well Replacement ❑ <br /> � I <br /> I <br /> Public Sewage Service Provider <br /> Disposal Annex-Formapon Distance to Public <br /> Existing 13 Required Sewer Facility I <br /> Proposed❑ <br /> I <br /> On-site Sewage Existing Septic System VINOW Septic System O Other 0 <br /> Disposal <br /> Publlc Storm Service Provider Annex-Formation Termlrt8l Drainage Detention <br /> - <br /> Existing C3istinDraInge Required to: Retention Ponds <br /> Proposed❑ , <br /> Private Storm On-site Retention Poril❑ <br /> Drainage Natural DralnagaJNo Change Other ❑ <br /> Service Provider Distance to Service Provider Distance to l <br /> Service Service <br /> MIN <br /> , 7elep onaServlc�e <br /> Service Provider Distance to Service Provider Distance to <br /> Service Service <br /> Service Provider Distance to Elam Service Provider Distance to Fire <br /> School Station <br /> m <br /> Road/StreetName R.O.W. Width Pavement"Width Curb/Guiter S! walks <br /> ' <br /> ✓�� ` �D r �� �� Yes© No Yes❑ _No 1� <br /> II Yea❑ NBIRK <br /> o❑ Y Yes❑ <br /> : .x W <br /> Road/Street Name R.O.W. Width Pavement Width CutWGutter Sidewalks <br /> Yes❑ No❑ Yes 0 No❑ <br /> I; <br /> I Yes❑ No❑ Yes❑ No 13 <br /> '1 <br /> 1:41 PMPA LA90 Fal I,IM , <br /> -3- <br /> I <br /> P <br /> „ <br />