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. a APPLICATION - LOT LINE ADJUSTMENT `{ SAWN JOAQUIN COUNTY COMMUNITY DEVELCPMENT CEPAr2`1fEN'T FILE NUNIKR: j� PROPOSED PARCELS I! Existing SquareTFoc Proposed Square Parcel Number Existin or Pr000sed Use of Parcel Footage or Acreagetaeor Acrea e i Lot 1 Residence/Nursery Ex. 21.8 acre 5 acres Lot 2 Barelland 2 acre 19 acres •2 SITE IMPROVEMENTS AND SERVICES Water !! Annex-Formation Distance to Public Public Water I Service Provider Required Water Feet Proposed ❑ �� Existin ❑ Private Water® ! Existing Well New Well ❑ Well Replacement ❑ Sewage Disposal Public Sewage Annex-Formation Distance to Public Disposal Service Provider Requited Sewer Facility Proposed ❑ Existin ❑ On-site Sewage Dis osal ® IlExisting Se tic System ® New Se tic System ❑ Other ❑ Storm Drainage Public Storm Drainage Service Provider(if Public) Annex-Formation Terminal Drainage Detention-Retention Proposed ❑ Required to: Ponds Existing❑ Private Storm I' Drainage ❑ _!`On-site Retention Pond s ❑ Natural Draina a/No Chane ® Other ❑ Electricity Telephone Service i Distance to Service Provider h Service Service Provider Distance to Service P On—site On—site School Service Fire Protection Service a Distance to Elem Service Provider p School Service Provider Distance to Fire Station Lodi Unified '! S miles Woodbridge 6 miles Existing Roads RoadlStreet Name R.O.W. Width Pavement Width Curb/Gutter Sidewalks State HW Rte. 12 105 Fee Yes❑ No ® Yes ❑ No �] Yes❑ No ❑ Yes ❑ No ❑ ii Proposed Roads Road/Street Name R.O.W.Width Pavement Width Curb/Gutter Sidewalks ,i Yes❑ No ❑ Yes ❑ No ❑ I! ,I Yes❑ No ❑ Yes ❑ Nc ❑ F 10EV5VC',PIanning Apol!callon F;rms, ii Page G of 7 IIS Ln Line Atllu Slmen:&,C ;Revised 6-4.04) o-