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APPLICATION - LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> BORN <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage <br /> 1 Agriculture w/Residence 1.47 Acres <br /> 2 Agriculture 18.55 Acres <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formai ion Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed Fl <br /> Existing❑ <br /> Private Water® Existin 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 ® 1 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 Pond(s) ❑ Natural Drainage/No Change N Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> PG&E Existing AT&T Existing <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> State Highway Route No. 120 60' 447(Estimate) Yes❑ No N Yes❑ No N <br /> Henry Road 40' 24' (Estimate) Yes❑ No N Yes❑ No N <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 /> FADEVSVCTianning Application Fonns\ Page 2 of 3 Job No 2015-138 LLA <br /> Lot Line Adlustment.doc.(Revised 05-11-09) <br />