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i jDPLICATION - LE ADJUSTMENT SAN JOAQUIN,COUNTY COMMUNITY DEVELOPMENT DEPARTMENT FILE NUMBER: PROPOSED PARCELS Existing Square Proposed Square Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage 1 Residence&Agriculture 33.4 +/-acres 10 +1-acres 2 Residence&Agriculture 33.4 +1-acres 56.8 +l-acres SITE IMPROVEMENTS AND SERVICES Water Annex-Formation Distance to Public Public Water Service Provider Required Water Feet Proposed ❑ Existing ❑ =Private Water ✓❑ Existing Well ❑✓ New Well ❑ Well Replacement ❑ Sewage Disposal Public Sewage Annex-Formation Distance to Public Disposal Service Provider Required Sewer Facilit Proposed ❑ Existin ❑ On-site Sewage Disposal Existing Septic System New Septic S stem ❑ Other ❑ Storm Drainage Public Storm Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention Proposed 71Required to: Ponds Existing ❑ Private Storm Drainage On-site Retention Ponds ❑ Natural Drainage/No Change Q Other ❑ Electricity Telephone Service Distance to Service Provider Service Service Provider Distance to Service PG& E on-site AT&T on-site School Service Fire Protection Service Distance to Elem Service Provider School Service Provider Distance to Fire Station { Galt Joint Union 3 miles Liberty Fire District 5 miles i Existing Roads Road/Street Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks Jahant Road 30' 24' Yes ❑ No ❑ Yes ❑ No 0 Yes ❑ No ❑ Yes ❑ No ❑ Proposed Roads RoadlStreet Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ Yes ❑ No ❑ F:0EVSVC\PIanning Application Forms\ Page 4 of 7 Lot Line Adjustment.doc.(Revised 6-4-04)