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qir' APPLICATION - LOT LINE ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT FILE NUMBER: PROPOSED PARCE4» a Existing or Proposed Use of Parcel Footage or Existing Square Proposed Square Parcel Number Acreage Foota e or Acreage 1 Agriculture w/Residence 10.00 ac-gross 2 Agriculture w/Residence 54.85 ac.gross i SITE1MFIROVEA i T, ANDSERiCtCES Annex-Formation Distance to Public Public Water Service Provider ProposeRequired Water Feet Existingd Private Water® Existin Well ® Now Well ❑ Well Replacement ❑ _ : 'Sevrage Dsposat Public Sewage Annex-Formation Distance to Public Disposal Service Provider Required Sewer Facility Proposed ❑ Existing ❑ On-site Sewage Dis osal ® Existing Septic System ® New Septic System ❑ Other ❑ . , Storm Drainage u _ ., Public Storm Drainage Service Provider (if Public) Annex-Formation Terminal Drainage Detention-Retention Proposed ❑ Required to: Ponds Existing ❑ Private Storm Drainage ® On-site Retention Ponds ❑ Natural Drainage/No Chane ® Other ❑ Etcctricrty � r ! a° Telephone'Seryice Distance to I Service Provider Service Service Provider Distance to Service PG&E Existing AT&T Existing School Serrrice F' Ere Protectiort,_Seryce. Service Provider Distance c to ElemService Provider Distance. ... to Fire Station Delta Island 11 miles Unprotected :,moi EXtstin floods Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks Highway Route No,4 Varies Varies Yes ❑ No® Yes ❑ No Roberts Road 60' &70' 26' (Estimate) Yes ❑ No® Yes ❑ No Y Pro sed Roads r h Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks N/A Yes ❑ No❑ Yes ❑ No❑ Yes ❑ No ❑ Yes ❑ No❑ i F:DEVSVC4Planning Application Forms\ Page 2 of 3 Job No 2011-28 Lot Line Adjustment.doc Lot Line Adjostment.doc, (Revised 6-4-D4) i