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Al, ?LICATION - LOT L11.c ADJUSTMENT <br /> 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 Acreage Footage or Acreage <br /> rd- g,SZ ti-c_ t/ <br /> �--. X r 'fit--rL,,L•f OTL'Gi vG�� O, �d0-�1-�-�/ <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed❑ <br /> Existing <br /> ❑ <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 Facility <br /> Proposed❑ <br /> Existin ❑ <br /> On-site Sewae <br /> Dis osal ' Existing Septic System New Septic System ❑ Other ❑ <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 StorT <br /> Drainage On-site Retention Ponds ❑ Natural Drainage/No Chane [�K 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 /> "e lka <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> tJ Yes❑ No E�_ Yes❑ No f!l <br /> Yes[_1 No❑ Yes El No <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No[- Yes❑ No <br /> Yes ❑ No❑ Yes❑ No❑ <br /> F:\DEVSVC\Planning Application Forms\ Page 4 of 7 <br /> Lot Line Adjustment.doc.(Revised 05-11-09) <br />