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APPLICATION - LOT LINE ADJUSTMENT
<br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
<br /> Parcel Number Existing or Proposed Use of Parcel Existing Proposed
<br /> Square Footage Square Footage
<br /> or Acrongo or Acreage
<br /> lad
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<br /> Service Provider Annex-Formation _ Distance to Public
<br /> Public Water t Required Water (Feet)
<br /> o. ., x
<br /> Private Water C Existing Well a New Well ❑ Well Replacement ❑
<br /> IT
<br /> MR
<br /> Public Sewage Service Provider Annex-Formation Dislonco to Public
<br /> Disposal 0 Required Sowor Facility
<br /> On-site Sews a Existing Septic System X New Septic System ❑ Other ❑
<br /> Disposal
<br /> l:L?r.,-
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<br /> Public Storm Service Provider Annex-Formation Terminal Drainage Detunllon-
<br /> Drainage ❑ Required to: Retention Ponds
<br /> Drainage Private Storm On-site
<br /> On-site Retention Pond(s) Natural Drainage/No Change G Other ❑
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<br /> Service Provider Distance to Service Service Provider Distance to
<br /> Service i
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<br /> Service Provider Distance to Service Service Provider Distance to
<br /> Service
<br /> FAC P2C- L4,
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<br /> Service Provlder Distance to Elem Service Provider Distance to Fire
<br /> Schon! Sintion
<br /> A
<br /> Izs YI
<br /> }} 'Sapp-
<br /> Name R,O.W.Width Pavement Width Curb/Gutter Sidewalks
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<br /> Yes ❑ No O Yo.- Ca N00
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<br /> Yes❑ No ❑ Yos CJ No ❑
<br /> Yes q No❑ Yes ❑ No ❑
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