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DocuSign Envelope ID: 1 E79170B-8EE4-44B7-A3CB-7E3B56CA49E7 J 'PLICATION - LOT L XADJUSTMENT ).•'.�LL�'•.O a SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT FILE NUMBER: q�iFOR� PROPOSED PARCELS Existing Square Proposed Square Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage R-22 Proposed Retail 39,248± SF 65,699± SF R-23 Proposed Retail 58,752± SF 60,688± SF R-26 Proposed Market 5.22± AC 5.14± AC R-27 Proposed Fuel Center 66,240± SF 41,352± SF SITE IMPROVEMENTS AND SERVICES Water Annex-Formation Distance to Public Public Water Service Provider Required Water Feet Proposed ❑ Existing ❑ Mountain House Community Services District Private Water X❑ Existing-Well ❑ New Well ❑ Well Replacemen ❑ Sewage Disposal Public Sewage IAnnex-Formation Distance to Public Disposal Service Provider Required Sewer Facility Proposed ❑ Mountain House Community Services District Existinci ❑ On-site Sewage Disposal ❑ Existing Septic System ❑ New Septic System ❑ Other ❑ Storm Drainage Public Storm Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention Proposed ❑ Required to: Ponds Existing ❑ Private Storm Drainage 0 On-site Retention Ponds ❑ Natural Drainage/No Chane ❑ Other ❑ Electricity Telephone Service Distance to Service Provider Service Service Provider Distance to Service School Service Fire Protection Service Distance to Elem Service Provider School Service Provider Distance to Fire Station Existing Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks Yes ❑ No ❑ Yes ❑ No ❑ Yes❑ No ❑ Yes❑ No ❑ Proposed Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks Yes ❑ No ❑ Yes ❑ No❑ Yes ❑ No ❑ Yes ❑ No❑ F:\DEVSVC\Planning Application Forms\ Page 4 of 7 Lot Line Adjustment.doc.(Revised 6-4-04)