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R�'.. APPLICATION — LOT LINE ADJUSTMENT <br /> x ° SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage FooU or Acrea a <br /> a'10- QZWOD a, Ac 46 AC <br /> -D?o- ► ^ acs c <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Pubic <br /> Public Water Service Provider Ra uired Water(Feet) - <br /> Proposed❑ <br /> ExistingSI <br /> Private Water Existing Well iZ New Well Well Re lacement <br /> Sewage Disposal <br /> Public Sewage- Annex-Formation I Distencelo Public <br /> Disposal Service Provider Re uired Sewer Facility <br /> Proposed❑ �! <br /> Exist Ci <br /> On-site Sewage <br /> blit sai E9 Existing Se tic S stem New Se tic S alem ❑ Olher <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex•Formation Terminal Drainage Detentlan-Retention <br /> Proposed[IRe uired to: Ponds <br /> Existing Q <br /> Private Storm <br /> Dmina aOn-site Retention Ponds Natural Drains a/No Chan a Other <br /> Electricity Telephone Service <br /> Dlstarwe to <br /> Service Provider Service Service Provider Distance to Service <br /> P6 s W6 1 q'r T tie <br /> School Service - Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> 2 rilzi, vis ' 3 M I t.Es <br /> Existina Roads <br /> Road/Street Name R.O.W.Witllh Pavement Width CurbiGutter Sidewalks <br /> Or '2 .JrQr Yes❑ Nc� YesD Noj4 <br /> Yes❑ No❑ Yes❑ No❑ <br /> prop""Roads <br /> Road/Street Name R.O.W.Width I Pavement Width Curb/Gutter Sidewalks <br /> 66 Yes❑ No❑ Yos❑ No❑ <br /> I <br /> Yea❑ No❑ Yes❑ No❑ <br /> F9DEVSVPPI1nM19 Applbellao Format Page 4 of 7 <br /> lot LJne ACIaslmenLd=(Revls 05-11-0e) <br />