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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: . <br /> FC �+ <br /> Parcel Number E)dstirm or ..Proposed <br /> e 'Use of ParcelEwsting Square Proposed Square <br /> FaIll or Acreage 4astalle,or Acreagis <br /> � Z v <br /> 15 <br /> a <br /> ¢, <br /> Public Water Service Provider Annex-Formation .-i.. Distance to Public,;;', <br /> Proposed❑ Required Water Feet <br /> Exstl <br /> Private Water E As b2 g Well I <br /> Hca New Well <br /> Public Sewage .. <br /> ��❑ Service Provider .. . . Annex-Fuired n Distance to Public . <br /> wired Seater Fara <br /> Erdsti <br /> Onsita <br /> Dr Exrsti Sol 6c System46 wSepticsystem ❑ Other ❑ <br /> Public Storm~ <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage DetentiorrReterrton <br /> Proposed❑ Required to: Ponds <br /> Existing❑ <br /> Private Storm <br /> Drer .. On-site Retention Ponds Natural Dre e/No _ OtlreEl <br /> r <br /> city) �' '� Lgletbrib-, ertiYi@ - <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> IM <br /> $c(t6bi8�Vit IxlYajli <br /> Distance to Elam <br /> Service Provider <br /> School Service Provider Distance to Fire Station <br /> AA . <br /> RoadlStreet Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks .- <br /> G Yes❑ No U Yes❑ No 5? <br /> Yes❑ No❑ Yes❑ No❑ <br /> R �hJ <br /> RoadfStl Name s R.O.W.Width Pavement Wil Curb/Gutter Sidewalks <br /> as❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> FADEV8VC1Pt WftAwnFgms\ Page 4of7 <br /> Lot U%AgUs6rimAxI c.(Revised 13&11-09) <br />