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,/op4� .cQ APPLICATION - LOT LINE ADJUSTMENT <br /> 27, SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> � '^ FILE NUMBER: <br /> ORN• <br /> PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Foots a or Acrea e <br /> i h y Z-O qt- <br /> SITE IMPROVEMENTS AND SERVICES <br /> Water <br /> Annex-Formation Distance to Public <br /> Public Water Service Provider Required Water Feet <br /> Proposed ❑ <br /> Existin <br /> Private Water Existing Well EL New Well Well Replacement ❑ <br /> Sewage Disposal <br /> Pt <br /> e Annex-Formation Distance to Public <br /> Service Provider Required Sewer Facili <br /> P <br /> On-site Sewa[sge <br /> Disposal 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 ❑ <br /> Required to: Ponds <br /> Existing ❑ <br /> Pivate Storm <br /> Drains a®- I On-site Retention Ponds ❑ Natural Drains e/No Chan a [Q Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> s GDv-j irE 1 -S /7-6- <br /> School <br /> -rtSchool Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> Coll n.' 3ai (/- <br /> Existing Roads <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> G( i t gZ- �t — I Yes❑ No Yes ❑ No�5 <br /> u2Y l-lVa4- /mac+ lJ Yes ❑ No [)} Yes ❑ No K <br /> Propose 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 OEVSVC�Planninij Application Formsl Page 4 of 7 <br /> Lot Line Adjustment dic (Revised 84-04) <br />