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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> N: X <br /> FILE NUMBER: <br /> C`q• � `p <br /> ]FQ�� <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage <br /> -S., r` ® 7-1.3 f y- 5/0 , <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed❑ <br /> Existing❑ <br /> Private Water[ Existing Well ED' 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 0' New Septic System ❑ Other ❑ <br /> Stone Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed ❑ Required to: Ponds <br /> Existing17 <br /> ❑ <br /> Private Storm <br /> Draina a[1 On-site Retention Ponds ❑ Natural Drainage/No Change Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> ,y cl c i r' Fs / <br /> School Service Fire Protection Service <br /> Service Provider Distance to ElemSchool Service Provider Distance to Fire Station <br /> L�i�ir�T T-k/f- C�+��iF+✓ 3 M 47- Gibe-)(I Ye <br /> Se •al f <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Z-1` e Z c r-d_ Yes ❑ No[r} Yes❑ No <br /> /2ce d 4ZI' Z,5 - Yes ❑ No Q 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 /> F:\DEVSVC\Planning Application Forms\ Page 4 of 7 <br /> Lot Line Adjustment.doc.(Revised 6-4-04) <br />