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ArPLICATION LOT Ll' 'E ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> PROPOSED PARCELS .. . <br /> Paine!Number Existing or ProUse of Parcel Existing Square �1p Square <br /> Foo a or aFootaae or Acreage <br /> 9 5 �►�� Rvl�L �s �N;tAc. Gn rc ctu Gno31P 0.ibac.41_ o, 9S tkc. t <br /> -L LA ILCe <br /> GrwSs 4c. 10 L t <br /> SITE IMPROVEMENTS AND SERVICES <br /> VYaber <br /> Public od W Service Provider Annex-FormationRu� Dista(Feet) <br /> E:dsti Private ❑ <br /> Water EAstinq Well New We#I Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-I=orrnation Distto Pu <br /> Disposal Service Provider R uin� Seawerrroe blic <br /> Facil' <br /> Proposed[I . <br /> Existing 0 <br /> Onsite Sewage �.ngfas t/1 Fwc 5 nh�� pin cr� <br /> Disposal El UstiSeptic S �►nd�ASAWAQVto Now S c o(her ❑ <br /> Storm Drainage <br /> Public Storm <br /> Proposed <br /> Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Required to: Ponds <br /> Fadsting❑ <br /> Private Storm <br /> Dral On-site Retention Ponds Natural Drain <br /> Electrlclly other <br /> Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> Q, i� <br /> A%VtjV %i VE-AiToA/ <br /> School Service Fire Protection Service <br /> Service Provider Distance to EFeni <br /> Schoo# I Service Provider Distance to Fre Station <br /> 1� i✓ 54 r�OL .j Lti <br /> Ex" Roads . <br /> Road/Street Name RO.W.Width Pavement Width Curb/Gutter Sidewalks <br /> FAA r✓ c f L L f-4ive- PAiVA 1`,t Z t7 N A Yes❑ No J$Wewalks <br /> M vA P t PAD i- <br /> F F i. - Yes❑ N PnMosedRaadsRoad/Street Name RO_W.Width Pavement WidthCurWGutterYes❑ No❑Yes❑ No❑ <br /> FADEvsvawremmy Apkskm Fw=j Page 4 of 7 <br /> LM ane Adi+>sMmtom(Revised 64.04) <br />