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Pa�Itr >a o APPLICATION — LOT LINE ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT FILE NUMBER: PROPOSED PARCELS Parcel Number Existing Square Existing or Proposed Use of Parcel Footage or Acre a a Proposed Square Footage or Acreage 119 -IW -IO Gn15Tl8C,- HRGEL ONE - 4EN.ERAL INOONRt L. R% 7140 A\ -PAR 0 - 04EKERA6INOVaipA 5357AC CEL LAE - s 103. Lion Ac- PgRGEI. Two I1 61 . 2522 AC SITE IMPROVEMENTS AND SERVICES Water Public Water Service Provider Annex -Formation Required Distance to Public Water Feet Proposed ❑ Existinq t Private Water Pf ,,/ ExistingWell IJ New Well ❑ Well Replacement ❑ Sewage Disposal Public Sewage Disposal Service Provider Annex -Formation Required Distance to Public Sewer Facility Proposed rJ Existin On-site Seway� Disposal Q Septic System New Septic System ❑ Other ❑ —Existing Storm Drainage Public Storm Drainage Proposed ❑ Service Provider (if Public) Annex -Formation Required Terminal Drainage to: Detention -Retention Ponds Existing Private Storm Drain a a [v]' On-site Retention Ponds ❑ Natural Drainage/No Chan e [� Other ❑ Electricity Telephone Service Service Provider Distance to I Service Service Provider Distance to Service PC, CE1 61 T School Service Fire Protection Service Distance to Elem Service Provider School Service Provider Distance to Fire Station T9Ac4 OAIIFIED SCHOOL DrSlA& I MIL -11L GO OF T004 FIRF PEPARtnA or 3 MILES Existing Roads Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks ARBOR AvENVE NOuy mve $o I Yes El No Yes No swap ROAD 40 / Yes [1 No ❑ Yes ❑ No [r Proposed Roads Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks N Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ F:\DEVSVMPianning Application Forms\ Page 4 of 7 Lot Line Adjustment.doc. (Revised 6-4-04)