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APPLICATION - LOT LWE ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT FILE NUMBER: Li�oR PROPOSED PARCELS Existing Square Proposed Square Parcel Number Existing or Proposed Use of Parcel Foots a or Acres a Foots a or Acreage ,,020-.Of? f siw a `Z :-1 -Z EaC. _ 2 --7-L- t ..! SITE:IMPROVEMENTS AND SERVICES .. +�.. ... .:>.' R✓..w �' .. ..:. .r.,✓.i_ {,. v.. . ..�.� t '-c_ <, {.. mo�ww-- _ qA'4 .vh. ..d. h.`1-. �LQf wy tis e nex=:Formation "Distarice'to Pubic . Public Water Service Provider Required Water Feet Proposed❑ Existin ❑ i Private WaLerZ Existing Well IR New Well Well Replacement ❑ Sewage Disposal Public Sewage : Annex-Formation Distance to Public Disposal I Service Provider Required Sewer Facili Proposed❑ Existing❑ 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❑ ' R uired to: Ponds Existing❑ Private Storm Drainage On-site Retention Pond s ❑ Natural Drainage/No Change IN Other ❑ Electricity Telephone.Service Distance to Service Provider Service Service Provider Distance to Service . .; Filre�.Pro#ec�iort Service . pp Distance to Elem Service Provider f School Service Provider Distance to Fire Station r T �Txbc_, s-+ Z., L-12-V e-44- Z,� NV 70 Sr4� Z i o j,,J�-r U'Lj wceb Ex€stip'Roads Road/Street Name R.Q.W.Width I Pavement Width Curb/Gutter Sidewalks eL_1 U& 1 1-0 Yes❑ No® Yes❑ No 4j cs Ad Go Yes❑ No❑ Yes❑ No❑ i. I Proposed Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks Yes❑ No❑ Yes❑ No❑ Yes❑ No❑ Yes❑ No❑ F:IDEVSVOPlanning Application Fomtsl Page 4 of 7 Lot Llne AdjustrnerrWm(Revised 6-4-04)