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op4�tN. APPLICATION — LOT LINE ADJUSTMENT <br /> e' % SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> N: < <br /> • i FILE NUMBER <br /> : <br /> 9�rFORN; <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage <br /> Oo -1 -15 „17,at_ 2. . 'lI A016. Z3 AeS. <br /> oo7-/so - _(�#A 10.82 Aes 6 .b Ac <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> rExisting <br /> ublic Water Service Provider Required Water Feet <br /> ropoed❑ <br /> ❑ <br /> Private Water[✓]� Existing Well 9?1�* New Well ❑ Well Replacement ❑ <br /> Sewage Disposal <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal Service Provider Required Sewer <br /> Facili <br /> Proposed❑ <br /> Existin ❑ <br /> On-site Sewa9� <br /> Disposal LST Existing Septic System E?"'� 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 /> Prvate Storm <br /> Draina e On-site Retention Ponds ❑ Natural Drainage/No Chane Ly- Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> P. G-7 + - 1 elRe- 1601 <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> r4lE V IUl ELe.M, <br /> m i e e, �.rf3�2 i 1' 6 1-A ; I� <br /> Existing Roads <br /> Road/Street Name I R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> A 10 j 60, Yes❑ No RrI Yes❑ No <br /> Yes❑ No❑ Yes ❑ No❑ <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes❑ No❑ Yes ❑ No❑ <br /> Yes❑ No❑ Yes ❑ No❑ <br /> FADEVSMPlanning Application Formsl Page 4 of 7 <br /> Lot Line Adjustment.doc.(Revised 05-11-09) <br />