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f - <br /> SERVICES <br /> Service Facilities Needed City, Special District, etc. <br /> Water 4.) <br /> Sewage <br /> Drainage <br /> Electricit f�•;s = r-'G �- <br /> Gas <br /> What is the purpose of the proposed Line Line Adjustment: %Z <br /> 41 <br /> Proposed property size and use: <br /> Parcel A size: use: <br /> Parcel B size• use: <br /> Parcel C size: use: <br /> ;y <br /> Parcel D size: 1/ .� � �� use: /,�,�<< s <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 /> Corporate Officer (s ) empowered to sign for the corporation, <br /> LIOwner ' s legal agent having Power of Attorney for this action (a <br /> notarized Power of Attorney document must accompany the <br /> application ) , <br /> an that the fore oing is true and correct. <br /> • (Signature , ( a e ) <br /> (Signature ) (Date ) <br /> (Signature ) (Date ) <br /> (Signature ) (Date ) <br /> Lot Line Adjustment - 6 - (7/84 ) <br />