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�Q.ulty. CPPLICATION - LOT ( NE ADJUSTMENT <br /> IIIIIz " �� G SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> E i <br /> FILE NU <br /> MER: <br /> <<FOR <br /> - <br /> ,. <br /> Parcel Number Existing Square Proposed Square <br /> Existing or Proposed Use of Parcel Foote a or Acrea a Foote a or Acreage <br /> 1 Agriculture with residence 1.34 acres net <br /> 2 Agriculture 30.61 acres gross <br /> 3 Agriculture 34.77 acres gross <br /> SITE tMPROVEMENTS AND SERVICES;= i <br /> Public WaterService Provider <br /> Annex-Formation Distance to Public <br /> Proposed ❑ Required Water Feet <br /> Existin ❑ <br /> Private Water® Existing Well ® New Well ❑ Well Re lacement ❑ <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider <br /> Proposed❑ Required Sewer Facility <br /> Existin ❑ <br /> " On-site Sewage <br /> Disposal® Existing Septic System ® New Septic System ❑ Other ❑ <br /> ,-,Storer"Drainage ;� <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ I Required to: Ponds <br /> Existing❑ <br /> Private Storm <br /> Drainage® On-site Retention Pond s) Natural Drainage/No Chane ® Other ❑ <br /> Eiectricity_. 4 ,F Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> PG&E Existing SBC Existing <br /> School ServlceP.. . <br /> I=ire <br /> rotectlon Service <br /> Distance to Eiem <br /> Service Provider School Service Provider Distance to Fire Station <br /> New Jerusalem 2 miles Tracy 2 miles <br /> ,EXisti n:'Road <br /> Road/Street Name R.O,W.Width Pavement Width Curb/Gutter Sidewalks <br /> Koster Road 40-45' 28' (estimate) Yes❑ No® Yes ❑ No <br /> t >t <br /> #?ro osedRoads. <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> NIA Yes ❑ No❑ Yes❑ No❑ <br /> Yes ❑ No ELj Yes❑ No❑ <br /> F:\DEVSVMPlanning Application Forms\ Page 2 of 3 Job No 2005-280 <br /> Lot Line Adjustmenl.doc.(Revised 6-4-04) <br />