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<br /> APPLICATION w LOT LINE ADJUSTMENT
<br /> SAN JOAQUIN COUNTY COMMUMTY DEVELOPMENT DEPARTMENT. i
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<br /> Parcel Number ' Existing or Proposed Use of Parcel Existing Proposed
<br /> Square Footage Square Footage or
<br /> or Acres a Acreage
<br /> Oi e
<br /> vac on
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<br /> M.:" L.n,{n�: 4 rY
<br /> Public Wat Service Provider Annex-Formation Distance to Public
<br /> EXLn R uired Water Feet
<br /> Proposed /
<br /> I
<br /> Private Water C] Existing Well 0 New Well ❑ We"Re tacemertt p i
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<br /> Public Sewage Service Provider Annex-Formatlon Distance to public
<br /> Disposal Required Sewer Facility
<br /> Existing 0
<br /> Proposed❑
<br /> On-site Sewa a Existing Septic System( New Septic System Other 0
<br /> Dig oosa /
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<br /> Public Storm Service Provider Annex-Formatlon Terminal Drainage Detention-
<br /> Drainage Required to: Reterttlen Ponds
<br /> Existing❑ I
<br /> Proposed❑
<br /> Private Storm On-slte Retention Pond(s) ❑ Natural Drainage/f+fo Change Other ❑
<br /> Drama a 0
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<br /> ETectrfci )
<br /> PlatltraY:.csasj'�'�c
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<br /> Service Provider Distance to Service Service Provider Distance to Service
<br /> I
<br /> Tole
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<br /> Service Provider Distance to Service Service Provider Distance to Servfce
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<br /> Schoe6ServiceF..Y .. zFiteProtdctferaSeniYce.
<br /> Service Provider Distance to Elem Service Provider Distance to Fire
<br /> School + Station '
<br /> Existin '.Roans
<br /> RoadlStreet Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks
<br /> Aw, o f 2 2�1 Yes 0 No Yes[2 NX
<br /> ,J Yes❑ No p Yes❑ No Q
<br /> Pro osed Rdads... f
<br /> Road/Street Name R.O.W.Width Pavement Width Curb/Cutter Sidewalks
<br /> Yes❑ No❑ Yes D No❑
<br /> Yes 0 No❑ Yes 0 No 0
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