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Aw-PLICATION - LOT LII ADJUSTMENT <br /> y� SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> •P <br /> •�7FOR�` - - - - <br /> �` <br /> 3 <br /> Existing Square. Proposed Square <br /> Parcel Number Eidsting or Proposed Use of.Parcel Footage a or Acrea e.; Footage or.Acrea e: <br /> ; SITE'IMPRQI7 ME iT$AMp�S R1110E5 <br /> J <br /> Wster <br /> Annex-Formation Distance to Public <br /> Public Water. Service Provider Required Water Feet <br /> Proposed ❑ <br /> Existing.❑ <br /> Private Water Existing Weli ❑ New Well. Well Re lacement -❑ <br /> .:Sewage ptsposal' <br /> Public Sewage Annex-Formation Distance to Public <br /> Disposal' Service Provider Required Sewer Facili <br /> Proposed ❑ <br /> Existin ❑ <br /> On-site Se a e <br /> DisposalExisting Septic System New Septic System 'Other ❑ <br /> Storrs Drain ge <br /> Public Storm <br /> Drainage . Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed❑ Required to: Ponds <br /> Existing❑ <br /> Private Sto <br /> Drainage On-site Retention Ponds ❑ Natural Drainage/No Chane Other ❑ <br /> :1 <br /> Electricity Te[ephone;Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> G ON- Sit-F- PC <br /> School Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> ;N►rMG1qAaA :r(K qj '�ri ,2. 5' M <br /> Existing Roads <br /> Road/Street Name R.O.W.Width . Pavement Width Curb/Gutter Sidewalks <br /> uz: . AS � Yes❑ No Yes❑ No <br /> �L?A F/L AA) � �Q\ � t Yes ❑ No Yes❑ No <br /> Proposed Roads <br /> Road/Street Name R.Q.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Yes ❑ No ❑ Yes❑ No❑ <br /> Yes❑ No ❑ Yes ❑ No ❑ <br /> ROEVSVC91anningApplication Forms Page 4 of 7 <br /> Lot Line Adjustment.doc.(Revised 6-3-03) <br />