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APPLICATION —*LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> N: :I <br /> FILE NUMBER: <br /> 5�/FORS <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Foota a or Acreage <br /> Em-r P k exisnA-� WALAU- %2--Z,-77- AC 3-2.49 Ae-_ <br /> u>P,;-r PA-12CEL .VeW 00c.: 14(,-7-7 Ac- 10 . 00 A- c- <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed ❑ <br /> Existing ❑ <br /> Private Water WEST Existing Well New Well M CA 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 S stem ❑ Other ❑ <br /> Storm 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 11 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 /> oo' f- AT-4-r 300 <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> 6ALO.Q U N t It R/k I ITo <br /> Ex at ng Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> 4ttA)r)e— 2cl Yes ❑ No JZ Yes❑ Nom <br /> Yes❑ No❑ Yes❑ No❑ <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> No u t Yes❑ No ❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No❑ <br /> FADEVSMPlanning Application Pones\ Page 4 of 7 <br /> Lot Line Adjustrnentdcc.(Revised 0&11-W) <br />