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T APPLICATION - LOT LINE ADJUSTMENT _ SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT .�a FILE NUMBER PROPOSED PARCELS Existing Square Proposed Square Parcel Number 6dsti Proposed Use of Parcel Footage or Acreage Footage or Acreage 22S-070-140-000 '/Z Acct- Acr-s 0- 5 e x '12 Acres Acrec SITE IMPROVEMENTS AND SERVICES Water Annex-Formation Distance to Public Public Water Service Provider Required Water Feet Proposed❑ Existin ❑ t4A N A N A Private Water❑ Existing Well New Well ❑ Well Re lacement ❑ Sewage Disposal Public Sewage Annex-Formation Distance to Public Disposal N f1 Service Provider Required Sewer Facility Proposed ❑ Existing ❑ NI A N On-site Sewage ' ____2isposal ❑ Existing Septic System New Septic System ❑ Other ❑ Storrs Drainage Public Storm Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention Proposed ❑ Required to Ponds Existing N A A ZL Private Storm Drainage ❑ On-site Retention Ponds ❑ Natural Drainage/No Chane Other ❑ Electricity Telephone Service Distance to Service Provider Service - Service Provider Distance to Service - (-ISoN 1 100 F4 School Service Fire Protection Service Distance to Etem Service Provider School Service Provider Distance to Fire Station Qll}C CG Ulll I�a Imles qt ( - MGrl 2Cc FIr {q �J . n )lles Existing Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks G rc ve S Rimed Yes❑ No bd Yes❑ No C9 Yes❑ No❑ Yes ❑ No❑ Proposed Roads Road/Street Name R__ W.Width Pavement Width Curb/Gutter Sidewalks N/A Yes❑ No 2 . Yes❑ No Yes❑ No❑ Yes❑ No❑ F-DEVSVC11 dfa ing Appllmhm Foust Page 4 of 7 Lot Line Adrysxmenrdoc_(Revised 64-01)