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r r� <br /> SERVICES <br /> Service Facilities Needed City, Special District, etc. <br /> Water . <br /> Sewage <br /> Drainage <br /> Electricity <br /> Gas <br /> What is the purpose of the proposed Line Line Adjustment : /! / <br /> ��/)c<C 5 rlc� V <br /> Proposed property size and use: <br /> Parcel A size- use: <br /> Parcel B size: use : <br /> Parcel C size: "7 qs`�� 14, , use: /11,C4_5 f, <br /> Parcel D size: f; 4. . use: <br /> SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> Legal Owner ( s ) (All owners must sign as their names appear on the <br /> deed. ) , <br /> QCorporate Officer ( s ) empowered to sign for the corporation, <br /> �--1 Owner ' s legal agent having Power of Attorney for this action (a <br /> notarized Power of Attorney document must accompany the <br /> application ) , <br /> 4 i that the fore oing is true and correct . <br /> � � � i •. i :, � ,�_ Wil, <br /> (Signature )' ( ate ) <br /> (Signature ) (Date ) <br /> (Signature ) (Date ) <br /> (Signature ) (Date ) <br /> Lot Line Adjustment - 6 - ( 7/84 ) <br />