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APPLICATION - LOT LINE ADJUSTMENT SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT " ki t '5777,71 •., .1.,'..P FILE NUMBER: PROPOSED PARCELS Parcel Number Existing Square Proposed Square Existin or Proposed Use of Parcel Footage or Acreage Footar a oAcrea PGG e Z �jl=•St'�1�1(,` X1'.130 PrC,A-�T A 6 0%. toy Ptcn.`3 PGG 40.233 Acazs 3q,469, x;:t HOrnl S,iC 12. 1oII A cR%S 12. 6U'1 AcM S ACG / GG (� 24o.S� fRcr,�s 23p,.3t04 grhS SITE IMPROVEMENTS AND SERVICES Water Public Water Service Provider Annex-Formation Distance to Public Proposed F1Re uired Water Feet Existing❑ Private Water[ Existin2 Well [� New Well ❑ Well Replacement ❑ Public Sewage Sewage Disposal Disposal Annex-Formation Distance to Public Proposed F-1ReProvider Re uired Sewer Facilit Existin ❑ On-site Sewage Dis osal Q-- Existin Se tic S stem New Se tic S stem ❑ Other ❑ Public Storm Storm Drainage Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention Proposed❑ Required Existing❑ to Ponds Private Storm Drainage❑ On-site Retention Ponds ❑ Natural Draina a/No Chane ❑ Other Electricity Telephone Service ❑ Distance to Service Provider Service Service Provider PGEDistance to Service IOU, -�- School Service Fire Protection Service Distance to Elem Service Provider School Service Provider Distance to Fire Station i2A"_M scNoo, S.]w 2.4+ IIA,cEF S ,21✓ S_,oJ # of SJ W S } M%LES Existin Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks �1 PtSSp,J ftofin gyp' L' 2p' _ ZSR t Yes❑ No© Yes❑ No 91 Yes❑ No❑ Yes❑ No❑ Pro osed Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks N NSA �(k Yes❑ No❑ Yes❑ No❑ Yes❑ No ❑ Yes ❑ No❑ FF OEVSVCiPlanning Application Formsl Page 4 of 7 Lot Line Adjustment.doc.(Revised 05-11-09)