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APPLICATION - LOT LINE ADJUSTMENT <br /> ya SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> < FILE NUMBER: <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage <br /> 1 Agriculture and Residential 7.8 AC 8.9 AC <br /> 2 Agriculture and Residential 10.6 AC 9.5 AC <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-FormationDistance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed❑ <br /> Existing❑ <br /> Private Water® Existing Well ® New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed❑ <br /> _Existing ❑ <br /> On-site Sewage <br /> Disposal ® Existing Septic System ® New Septic System ❑ Other ❑ <br /> Stone Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ Required to: Ponds <br /> Existing ❑ <br /> Private Storm <br /> Drainage® On-site Retention Ponds ❑ Natural Drainage/No Chane ® Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> P.G.&E. Adjacent Frontier Adjacent <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> Escalon Unfied 0.5 Miles Farmington Fire Dept. 1 Mile <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> State Route 4 80' 45' Yes❑ No® Yes❑ No <br /> Yes❑ No❑ Yes❑ No❑ <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> N/A Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> F:\DEVSMPlanning Application Forms\ Page 4 of 7 <br /> Lot Line Adjustmentdoc.(Revised 05-11-09) <br />