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o�(N APPLICATION — LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ..CSP:. <br /> FILE NUMBER: <br /> 9<%FORS <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existin_q or Proposed Use of Parcel Foota a or Acrea a Foota a or Acreage <br /> EAIr P k ExisT-7Ak* OALdur z2, z 37.49 A-e— <br /> PA¢c U �StDF,ve� exisr/N4 26 L,.> 10 . 00 A- e. <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed ❑ <br /> Existinq ❑ <br /> Private Water WC-�<Existing Well New Well ® CA � Well Re lacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed ❑ <br /> Existina ti <br /> On-site Sewage <br /> Disposal Existing Septic System New Septic System ❑ 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 /> Draina a]81On-site Retention Ponds ❑ Natural Draina e/No Chane ® Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider I Service Service Provider Distance to Service <br /> E67oo� Ari 3co <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> c cgtnl jU1Jt AP-111tJ61 o <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> 0Wne— Yes Nola Yes El Nom <br /> Yes❑ No❑ Yes❑ No❑ <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Nv uE Yes❑ No❑ Yes ❑ No❑ <br /> Yes ❑ No❑ Yes❑ No ❑ <br /> F:\DEVSVC\Planning Application Forms\ Page 4 of 7 <br /> Lot Line Adjustrnentdm.(Revised 0511-09) <br />