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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> a: < <br /> FILE NUMBER: <br /> �iFBkN <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existin or Proposed Use of Parcel Footage or Acreage Footage or Acreage <br /> 1 Agriculture w/Residence 2.14 Ac.Gross <br /> 2 Agriculture 38.41 Ac. Gross <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water I Service Provider Required Water Feet <br /> Proposed ❑ <br /> Existing ❑ <br /> Private Water® Existing Well ® New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer Facility <br /> Proposed ❑ <br /> Existing❑ <br /> On-site Sewage <br /> Disposal® Existing Septic System ® New Septic System ❑ Other ❑ <br /> Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed ❑ Required to: Ponds <br /> Existing ❑ <br /> Private Storm <br /> Drainage ® On-site Retention Ponds ❑ Natural Drainage/No Chane ® Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> PG&E Existing SBC Existing <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> Lodi Unified 6 mi Mokelumne 6 ml <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Kettleman Lane 50' 26' (estimate) Yes❑ No® Yes ❑ No <br /> Yes El No El Yes[I No ElPro <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> N/A Yes❑ No❑ Yes ❑ No ❑ <br /> Yes❑ No❑ Yes ❑ No ❑ <br /> FADEVSMPlanning Application Forms\ Page 2 of 3 Job No 2016-05 LLA <br /> Lot Line Adjustment.doo.(Revised 6-4-141 <br />