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oequ''�. APPLICATION -- LOT LINE ADJUSTMENT <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: <br /> q[t;;obi <br /> `. PROPOSED PARCELS <br /> Existing Square Proposed Square <br /> Parcel Number Existing or Proposed Use of Parcel Footage or Acreage Footage or Acreage <br /> N 1 Homesite&Vineyard 3.86+1-acres 3.86+I-acres <br /> 2 Vineyard 3.86+1-acres 3.86+1-acres <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 Q Existing Well 2 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 /> Existin ❑ <br /> On-site Sewage <br /> Disposal Q Existing Septic System ❑ New Septic System_❑ Other ❑ <br /> k Storm Drainage <br /> Public Storm <br /> Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention <br /> Proposed ❑ Required to: 'Ponds <br /> I Existing❑ <br /> i Private Storm <br /> Drainage On-site Retention Ponds ❑ Natural Drainage/No Chane 0 Other ❑ <br /> Electricity Telephone Service <br /> Distance to <br /> Service Provider Service Service Provider Distance to Service <br /> PG&E on-site AT&T on-site <br /> Schooi Service Fire Protection Service <br /> Distance to Elem <br /> Service Provider School Service Provider Distance to Fire Station <br /> LUSD 2 miles Mokelumne Fire District 2 miles <br /> Existing Roads` <br /> Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks <br /> Highway 12 60 feet 40 feet Yes❑ No 0 Yes❑ No 0 <br /> Yes❑ No❑ Yes❑ No❑ <br /> Proposed Roads <br /> Road/Street Name R.O.W.Width Pavement Width CurblGutter Sidewalks <br /> Yes❑ No❑ Yes❑ No❑ <br /> Yes❑ No❑ Yes❑ No ❑ <br /> 4 VF��ADEVSVC\Planning Application Forms\ Page 4 of 7 <br /> Adjustment.doc.(Revised 6-4-04) <br />